Precision Oncology and Modernizing Evidence Standards: A Critical Commentary on the Cochrane Review

🟡 Single-arm studies with strong biomarker rationale can drive approvals
🟣 Tumor-agnostic evidence, early-line trials & RWE must be included—or we risk undervaluing #PrecisionOncology

#EvidenceBasedMedicine #CancerResearch #ClinicalTrials #PersonalizedMedicine

ascopubs.org/doi/10.1200/...

💫🌟🔥 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

Can't wait Andrea! 🙂

🚨 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....

#Immunotherapy #IOtoxicities
aacrjournals.org/cancerrescom...

💫🌟🎓🆕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

✅ GA captured frailty & comorbidities beyond routine clinical eval
⚖️ Supports tailored therapy for older/frail MM pts

#GeriOnc #OlderAdults #OncoAlert #SIOG #YoungSIOG #MultipleMyeloma

www.geriatriconcology.net/article/S187...

🧓👵 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

ELEVATE-ing clinical trial reporting in CLL In this issue of Blood, Sharman et al1 report on the latest 6-year follow-up of the ELEVATE-TN trial, which previously reported the superiority of acalabru

ELEVATE-ing clinical trial reporting in CLL buff.ly/FwUhcEw #hemesky

Breast Cancer in Young Women: When, Why, and How?
Melissa Troester, Kornelia Polyak, and Sherene Loi will address this question in an educational session at #SABCS25 (December 9-12). Learn more:
buff.ly/OB6T5Xs
@loisher.bsky.social

📌 Conclusion:
Neurotoxicity is a major survivorship challenge → need biomarkers, preventive strategies, multidisciplinary management.

#NeuroOncology #Neurotoxicity #CancerSurvivorship #MedEd

💡 Management strategies
🔹CIPN: dose modification, duloxetine, lifestyle interventions
🔹RT: hippocampal-sparing, memantine
🔹IO: steroids, early recognition

🧬 Mechanisms
🔹CIPN: axonal degeneration, ion channel changes, mitochondrial injury
🔹RT: neuroinflammation, vascular damage, neurogenesis impairment
🔹IO: autoimmunity & cytokine-driven CNS effects

🧪 Emerging biomarkers
➡️NfL, GFAP, imaging correlates

🧾 Scope
➡️Peripheral + central neurotoxicity across chemo, RT, IO
➡️Covers CIPN, RT-induced cognitive decline, IO-related neuro events

🧠 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...

Functional synapses between neurons and small cell lung cancer - Nature Small cell lung cancer cells form functional synapses with glutamatergic neurons, receiving synaptic transmissions and deriving a proliferative advantage from these interactions.

Functional synapses between neurons and small cell lung cancer

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

The @fda.gov has approved the gemcitabine intravesical system (Inlexzo) for adults with BCG-unresponsive non–muscle-invasive bladder cancer with CIS with/without papillary tumors.

In the SunRISe-1 trial: complete responses reported in 82%

ascopost.com/news/septemb...

🕯️ Today, we pause to remember the lives lost on September 11, 2001, and honor the courage of first responders, survivors, and families whose lives were forever changed.
May we continue to carry forward the lessons of unity, resilience, and compassion.

🌟🟠 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: Epidemiology, diagnosis and treatment Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related mortality worldwide and predominantly affects individuals with cirrhosis. While viral hepatitis has historically been the ma...

✅ Surveillance underused despite curative potential
✅ IO-based combos in advanced HCC → OS >2 yrs
➡️ Ongoing need: prevention, early dx, biomarkers & access

#LiverCancer #GIOnc #Immunotherapy
www.jhep-reports.eu/article/S258...

🟢 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

We are excited to announce the 2026 SITC EU Immuno-Oncology Drug Development Summit. Coming Sept. 2026 in Lausanne, Switzerland. This program will discuss best practices for modern IO drug development & the next wave of IO therapeutics. Join the waitlist: https://t.co/JhPLTpSvdb 🧪

We are excited to announce the 2026 SITC EU Immuno-Oncology Drug Development Summit. Coming Sept. 2026 in Lausanne, Switzerland. This program will discuss best practices for modern IO drug development & the next wave of IO therapeutics. Join the waitlist: t.co/JhPLTpSvdb 🧪

Fluctuating DNA methylation tracks cancer evolution at clinical scale - Nature Cancer evolutionary dynamics are quantitatively inferred using a method, EVOFLUx, applied to fluctuating DNA methylation.

Studying cancer evolution needs multi-region or single cell seq for phylogenetics, right? Amazingly (I think!) we found single-sample bulk methylation suffices, via analysis of "fluctuating methylation". In @nature.com today led by brilliant @calumgabbutt.bsky.social www.nature.com/articles/s41...

WU Hoo! The Promise of Allogeneic WU-CART-007 in Relapsed/Refractory T-Cell Malignancies Ghobadi A, Aldoss I, Maude SL, . Phase 1/2 trial of anti-CD7 allogenic WU-CART-007 in patients with relapsed/refractory T-cell malignancies. Blood. Publish

WU Hoo! The Promise of Allogeneic WU-CART-007 in Relapsed/Refractory T-Cell Malignancies url: ashpublications.org/thehematolog...

🔬 Conclusion: Perioperative Durvalumab in MIBC = clinically effective + socioeconomically justified

#BladderCancer #GUcancer #OncoTwitter #Immunotherapy #HealthEconomics #Medicalwatch 🚀

www.ejcancer.com/article/S095...

📢 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

The Cancer Planners Forum 2025, hosted by @uiccofficial.bsky.social with @who.int, @iaeaorg.bsky.social, etc held in May 2025 raised urgent global needs for cancer control plans.

Ulrika Årehed Kågström tells The ASCO Post about successes and remaining challenges

ascopost.com/news/septemb...

Manage toxicities associated with bispecific tarlatamab for small cell lung cancer! Learn from a panel of experts during SITC’s #virtual Advances in Cancer Immunotherapy: A Focus on Lung Cancers program Sept. 12. Learn more: https://ow.ly/I7HJ50WT8wW 🧪

Manage toxicities associated with bispecific tarlatamab for small cell lung cancer! Learn from a panel of experts during
SITC’s #virtual Advances in Cancer Immunotherapy: A Focus on Lung Cancers program Sept. 12. Learn more: ow.ly/I7HJ50WT8wW 🧪
@drjnaidoo.bsky.social

🎯 Clinical impact: ER-low BC should be managed more like TNBC, with inclusion in immunotherapy & ADC trials. Re-biopsy at relapse is crucial to detect phenotype switch.

#BreastCancer #ERlow #TNBC #Immunotherapy #Medicalwatch
aacrjournals.org/clincancerre...