Thank you. Agree, PSMA and PSA are just phenotypic markers that are demonstrably dispensable as mPC evolves under environmental and treatment selective pressure.
01.03.2026 02:51 — 👍 1 🔁 1 💬 0 📌 0Thank you. Agree, PSMA and PSA are just phenotypic markers that are demonstrably dispensable as mPC evolves under environmental and treatment selective pressure.
01.03.2026 02:51 — 👍 1 🔁 1 💬 0 📌 0Thank you. Could you expand? PSA response vs PSMA response - is one better?
27.02.2026 23:21 — 👍 1 🔁 1 💬 1 📌 0
Still in the Dark…
#PCWG4 launched #GU26 w/aspirational reliance on #PSMA imaging for drug development
But we will have to acknowledge that #PSMA targeted therapy will likely impact the sensitivity of #PSMA imaging
#PSMAdark
@ascocancer.bsky.social
@melissaabel20 et al
rdcu.be/eKNQe
The #NCI past meets the present #GU26 @ascocancer.bsky.social
Dr. Melissa Abel discusses emerging #PSMA tumor volume data with Dr. Harpreet Singh
The emerging data is from a follow-up trial based on a trial Dr. Singh worked on during her time at the NCi
More data on PSA
Almost none on PSMA
So I would not used PSMA “response” since all that really is telling us about fundamentally is #PSMA expression.
#ProstateCancer @ascocancer.bsky.social #GU26
“Dry Mouth” remains a frequent toxicity w/#PSMA therapies #GU26; easy to discount which is why worth reviewing below
There are no Grads 4/5 and grade 3 is TPN. Grade 2 is also no picnic for pts
We need a better grading system & more data on reversibility
#ProstateCancer
@ascocancer.bsky.social
Dr. Fred Saad presents #Trillium 225Ac-PSMA in #mCRPC phase 1 study
Substantial amount of dry mouth observed including 30% grade 2.
@ascocancer.bsky.social
#GU26
Dr. Fred Saad presents #Trillium 225Ac-PSMA in #mCRPC phase 1 study
Substantial amount of dry mouth observed including 30% grade 2.
@asco #GU26
Still in the Dark…
#PCWG4 launched @ascocancer.bsky.social #GU26 w/aspirational reliance on #PSMA imaging for drug development
But we will have to acknowledge that #PSMA targeted therapy will likely impact the sensitivity of #PSMA imaging
#PSMAdark
@melissaabel20 et al
rdcu.be/eKNQe
Drs. Melissa Abel & Alexandra Sokolova chair the #GU26 chair this evening Rapid Abstract Presentations in #ProstateCancer
@ascocancer.bsky.social
Poster A14
#GU26
@ascocancer.bsky.social
One key bit of data missing in the context of #PSMA+ #BCR #ProstateCancer management in the wake of the #EMBARK data is how does #PSA Doubling Time interface w/ #PSMA Pet findings.
Dr. Melissa Abel from #NCI will share this data today
PosterA4 #GU26
@ascocancer.bsky.social
#BCR #ProstateCancer study @thenci
🩻PSMA➡️ 3 mos Enza💊➡️PSMA🩻
PSA control=days below baseline=clinical benefit🔵
PSA⬇️88-100%🟠
#PSMA Tumor Volume🟢
🚨PSMA-TV⬇️s/p Enza does NOT predict benefit
These data in PSMA responders raise❓for adaptive designs
Oh I like this…
#GU26
You’ve just beautifully summarised the vast majority of “🚨BREAKING NEWS! 🚨” papers and social media posts that come out of so many major meetings these days. We definitely need to do better.
#GU26
🔜 #GU26 @ascocancer.bsky.social
How to approach a vast meeting w/so much data?
Look beyond data that repackages known truths but do NOT really advance understanding
Common examples:
1. Less cancer is better than more cancer
2. Responders do better
3. More treatments vs. less improves PFS
🔜 #GU26 @ascocancer.bsky.social
#ProstateCancer liver mets are lethal Finding at risk pts may be valuable
“Using this unique approach we have identified a candidate gene signature for detection of LM in advanced PCa using platforms such as EV-based liquid biopsy. Further studies are underway…”
🔜 #GU26 @ascocancer.bsky.social
“These findings… highlight the need for larger… studies to validate the prognostic value of PSMA-guided disease stratification & ensure its generalizability across diverse populations.”
Agree!! Need more #PSMA data less presumption in #ProstateCancer
🔜 #GU26 @ascocancer.bsky.social
Provocative early data
“#Microplastics were found in tissue samples from 9/10 pts w/ #prostatecancer…w/greater concentration in tumor tissue compared to benign tissue. Additional research is in progress to study the link between MNPs w/prostate carcinogenesis.”
🔜 #GU26 @ascocancer.bsky.social
“Detection of nodal and distant metastases below the Phoenix threshold challenges the current reliance on biochemical criteria to trigger imaging.”
Contemporary ❓But does early #PSMA+ #BCR #ProstateCancer require tx? Probably not based on data from the NCI @ #GU26
🔜 #gu26 @ascocancer.bsky.social
Would be good to see long term impact of ⬆️ PFS
“The addition of #enzalutamide to standard ADT resulted in an improvement of PFS following SRT, warranting a phase 3 trial... and did not identify new safety concerns.”
#ProstateCancer
🔜 #GU26 #ProstateCancer @ascocancer.bsky.social
Important New trial guidance is valuable but important to distinguish from clinic practice recommendations
“#PCWG4 expands guidance on patient & tumor profiling, as well as therapy development, to include both ADT sensitive & resistant settings…”
🔜 #GU26 @ascocancer.bsky.social
Key to note IHC+ synaptophysin/chromogranin (seen in #ProstateCancer adenocarcinoma and small cell) alone should not exclude pts from Lu-PSMA
Also highlights continue conflation of terms of #NEPC & small cell, the latter being truly virulent but also rare
🔜 #GU26 @ascocancer.bsky.social
PFS benefit less than I would have expected…
“The median (95% CI) PFS was 14.7 (11.7–21.3) mos among pts in the concomitant ARPI cohort vs 12.5 (11.5–13.6) months in the no concomitant therapy. Ongoing follow-up… on long-term clinical outcomes, including OS.”
With #GU26 approaching one key bit of data missing in the context of #PSMA+ #BCR #ProstateCancer management in the wake of the #EMBARK data is how does #PSA Doubling Time interface w/ #PSMA Pet findings.
Dr. Melissa Abel @ the NCI will share this data @ #GU26 @ascocancer.bsky.social
It’s the story of a group of experts, who are bringing insights on the latest science...
Announcing our lineup of experts who'll serve as #GU26 Featured Voices, sharing which abstracts they’re most interested in, putting the findings into context & taking you along for the journey.
Happy Holidays from your friends at the National Cancer Institute and NIH
24.12.2025 14:26 — 👍 0 🔁 0 💬 0 📌 0
Daily reminder:
#PSMA doesn't show everything...
100 pts w/#BCR #ProstateCancer s/p previous PSMA radioguided surgery
▶️median PSA=0.9
‼️91% recur@ median 11.4mos
‼️47%w/ distant recurrence beyond pelvis
Important for pts to be aware of these data
jnm.snmjournals.org/content/66/1...
What’s high risk #BCR #ProstateCancer?
PSA DT:best predictive biomarker in BCR; required for BCR trials
PSMA 🤷🏻♂️undefined role
EMA says HR is <12 months
EMBARK says <9 mos
Per @NCI BCR WG the data is most c/w <6 mos (see sankey👇 of MFS with NO therapy)
shorturl.at/HeEMh
@ascocancer.bsky.social
🦃Happy Thanksgiving 🦃
A special shout out to all you #DallasCowboys fans out there. (We all have a “complicated relationship”with this holiday 🤠)
👏🏼Interesting study #SBRT+/-#LuPSMA @ascocancer.bsky.social
⭐️Innovative design w/limited dosing of LuPSMA #oligorecurrent #ProstateCancer
❓What if all pts were MTD-Naive
🤔important differences in 🔑baseline characteristics favor combo
🤔PFS criteria w/❓clinical value
ascopubs.org/doi/pdf/10.1...