Medical.watch

💫🌟🔥 Hot off the press (Comments & Controversies)🌟💫

Thrilled to see the timely piece

👉 “Precision Oncology and Modernizing Evidence Standards”

🔑 Key takeaways:
🔵 RCT-only frameworks miss the reality of #PrecisionMedicine
🟢 Basket, umbrella & N-of-1 trials are cornerstones of #PrecisionOncology

🚨 NEJM | Sept 2025
Low-dose aspirin in PI3K-altered localized #ColorectalCancer (ALASCCA)

“Low-dose aspirin cut 3-yr recurrence by ~50% in PI3K-altered localized colorectal cancer.”
www.nejm.org/doi/full/10....

💫🌟🎓🆕Immune activation & ICI-related fatigue
New study (JHU + Genentech)

✅ 58.5% of pts on ICIs reported fatigue
✅ Fatigue linked to ↑ Th1 cytokines (IFN-γ, IL-2, IL-12)
✅ Expansion of CD8+ effector T cells
✅ Fatigue = surrogate of immune activation

🧓👵 Geriatric assessment vs clinical evaluation in MM
J Geriatr Oncol (Sept 2025, Raddoux et al.)
👏 Congrats to the authors & to the #GeriOnc community advancing care for older #MM patients.

📊 Prospective study in 200 older adults w/ newly diagnosed #MultipleMyeloma

🧠 Neurotoxicity in Cancer Therapy
New review (Nat Rev Clin Oncol)

✅ Pathophysiology of chemo-, RT- & IO-induced neurotoxicity
✅ Clinical recognition & biomarkers
✅ Prevention & management strategies

🔍 Key messages – Cavaletti, Cámara, DeAngelis et al. Nat Rev Clin Oncol 2025

Lymphomas: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up† The treatment landscape for many lymphoma entities continues to evolve rapidly, with multiple recent approvals of novel non-chemotherapy (ChT)-based approaches. The following Clinical Practice Guideli...

📑 New ESMO CPG on Lymphomas

✅ Updated dx & staging recs
✅ 1L & r/r treatment algorithms
✅ Integration of CAR-T, bispecifics & BTKis

www.annalsofoncology.org/article/S092...

🌟🟠 HER2 in mCRC
New pooled analysis in JCO
(8 RCTs, n=1,604)🌟

✅ HER2+ = worse PFS & OS
❌ Not predictive for Bev vs anti-EGFR
➡️ Prognostic, not predictive

#GIOnc #ColorectalCancer #mCRC #HER2 #Oncology #JCO #Medicalwatch

ascopubs.org/doi/10.1200/...

🟢 Hepatocellular carcinoma (HCC) – 2025 global insights 🌍
New open-access review (Mauro, de Castro, Zeitlhoefler, Villanueva, Mazzaferro, Llovet et al.)

🔑 Highlights:
✅ 3rd leading cause of cancer death
✅ Etiology shift → viral ↓ | ALD & MASLD ↑
✅ Prevention: HBV vax + antivirals effective

📢 European Journal of Cancer – New Research
Cost-effectiveness of perioperative Durvalumab + Gem/Cis in MIBC (Germany)

📊 Results:
➡️ Cost: €113,224 (SoC) → €126,386 (+€13,162)
➡️ QALYs: 3.16 → 3.37 (+0.21)
➡️ ICER: €61,006/QALY
➡️ WTP €100,000 → 76.5% probability of cost-effectiveness

🌍 #MWGlobalOnc
Prognosis & biology of ER-low metastatic breast cancer – TONIC & multicenter cohort

🔑 Key Messages:
✅ ER-low (1–9%) behaves biologically closer to TNBC than ER+/HER2−
✅ Worse OS vs ER+/HER2−; prognosis similar to TNBC
✅ Phenotypic switch from ER+ → ER-low at relapse = poor outcomes

Geriatric Assessment: ASCO Global Guideline | JCO Global Oncology ASCO Guidelines provide recommendations with comprehensive review and analyses of the relevant literature for each recommendation, following the guideline development process as outlined in the ASCO Guidelines Methodology Manual, ASCO Guidelines follow ...

✅ Barriers: resource gaps, training, access in LMICs

➡️ Clinical practice impact: GA should be mandatory in global oncology to optimize outcomes for older adults.

#GeriatricOncology #ASCO #OncoTwitter #Medicalwatch #CancerCare #GlobalOncology
ascopubs.org/doi/10.1200/...

Heading to an appointment this weekend? Plan ahead for street closures 🚧 👷 Aloha St. will be closed at Fairview Ave. N. from 7 p.m. Friday, 9/5 until 6 a.m. Monday, 9/8. This is part of the City of Seattle’s RapidRide J-Line construction project. bit.ly/47GyDV0

🎥 #MWVisualAbstract
Surgical complexity after NACT in primary ovarian cancer
✍️ Chiara Ainio, Marina Rosanu, Lucia Ribero, Amanda L. Tapia, Giovanni D. Aletti, William A. Cliby et al.

🔶 Key Messages:
➡️ >50% of pts undergoing IDS after NACT required advanced procedures

💡 #MWClinicalTips
FGFR1-amplified colorectal cancer: a distinct prognostic subtype

✅ Large-scale profiling (n=7606) → FGFR1 amplification = predominant FGFR alteration in CRC (≈4%).
✨ Independent marker of poor prognosis: ↓DFS (HR 2.91) & ↓PFS (HR 2.52).

#COTipTuesday

🔵 Prostate Cancer Statistics 2025 – CA Cancer J Clin

✅ 313,780 new cases & 35,770 deaths expected in US (2025)
✅ Incidence ↑ 3%/yr since 2014, driven by advanced-stage dx
✅ Distant-stage PCa rising across all ages 📈
✅ Black men: 67% ↑ incidence & ~2x mortality vs White men

🟢 Circulating KIM-1 in adjuvant #RCC

New Annals of Oncology analysis (IMmotion010):
✅ Elevated post-nephrectomy plasma KIM-1 = ↑ recurrence risk (HR 1.68)
✅ KIM-1high pts benefited from adjuvant atezo (HR 0.72)

🌟🫁 Early & locally advanced #NSCLC – New
@myESMO
Guidelines🌟

✅ Screening: LD-CT for heavy smokers (55–74y)
✅ Biomarkers: EGFR, ALK & PD-L1 testing essential
✅ Surgery: Sublobar resection ≈ lobectomy for ≤2cm tumors

🌟🧠 #MWThinkWednesday
Geriatric Assessment: ASCO Global Guideline 🌟

✅ GA is recommended for all adults ≥65 receiving cancer treatment
✨ Identifies vulnerabilities beyond chronological age (function, comorbidities, polypharmacy, nutrition, cognition, psychosocial health)

🧠 #MWThinkWednesday
Inferior control arms in oncology trials in LMICs: contextualised or compromised?

✅ Some oncology trials in LMICs still use inferior control arms vs HIC standards.
✅ Raises ethical concerns: are we contextualizing care or compromising patients?

💡 #MWClinicalTips
Brain imaging screening in metastatic breast cancer: patients’ & physicians’ perspectives

✅ 529 physicians (50 countries): 65% request BIS in asymptomatic MBC, mainly for HER2+ & TNBC

🌍 #MWGlobalOnc
Artificial intelligence across the cancer care continuum

✅ AI transforms oncology from prevention → survivorship → end-of-life care
✨ Early detection: deep learning predicts pancreatic & lung cancer risk yrs before diagnosis

🌟🚀 Novel trial designs in the era of molecular oncology🌟

🔑 Key insights:
✅ Molecular reclassification is reshaping cancer trial paradigms
✅ Basket & umbrella designs accelerate drug development across tumor types
✅ Adaptive, platform & seamless trials enable faster, more efficient testing

Newly diagnosed acute myeloid leukemia in unfit patients: 2026 treatment algorithms - Blood Cancer Journal Blood Cancer Journal - Newly diagnosed acute myeloid leukemia in unfit patients: 2026 treatment algorithms

🧬 New AML care update for unfit patients
Ven + HMA = current backbone ⚡️
CR/CRi ~40–90%, 3-yr OS up to 67% 📈 (better w/ NPM1, IDH2; worse w/ TP53, FLT3-ITD)

Future: refine triplets ➕ optimize dosing, ASCT timing, & add PROs 🗣️

www.nature.com/articles/s41...

💡 #MWClinicalTips
📢 Advances in Neuroendocrine Tumors (NETs) — therapeutic landscape update

✅ NETs are highly heterogeneous — site of origin & biology determine management.
✅ Somatostatin analogs remain backbone for symptom & tumor control.

💡 #MWClinicalTips
📢 IMvigor011 trial: ctDNA-guided adjuvant immunotherapy in MIBC. Natera & Genentech/Roche

✅ Signatera-positive pts + atezolizumab → significant ↑ DFS & OS
✅ Signatera-negative pts → excellent outcomes w/out adjuvant Rx

Treatment of NSCLC after chemoimmunotherapy — are we making headway? - Nature Reviews Clinical Oncology Immune-checkpoint inhibitors have dramatically improved the outcomes in patients with advanced-stage driver-negative non-small-cell lung cancer (NSCLC), although most patients will ultimately have dis...

💡 Take-home message: Restoring antitumor immunity via multimodal, biomarker-guided strategies is the next frontier in post-ICI NSCLC.

#LungCancer #NSCLC #ImmunoOncology #CheckpointInhibitors #Medicalwatch
www.nature.com/articles/s41...

➡️ Emerging strategies: bispecifics, T cell engagers, ADCs, targeted therapies, adoptive cell therapy, vaccines, intratumoral IO.
📈 Biomarker-driven adaptive trials are key to navigating resistance & accelerating novel therapies.

🌍 #MWGlobalOnc ✨
Treatment of NSCLC after chemoimmunotherapy — are we making headway?

✅ Most NSCLC pts eventually develop resistance to ICIs (primary 5–20%, secondary 60–85%).
✨ Resistance mechanisms converge into an immunosuppressive TME.