Dr Jorge Rodriguez Pulido

🚨 New ASCO Guidelines (2026): Medullary Thyroid Cancer (MTC) This is now a RET-driven disease Your first decision = mutation status 🧠 Step 1: Test for RET mutation 🔥 RET-mutant MTC 👉 Selpercatinib = preferred FIRST-LINE 📊 LIBRETTO-001 • ORR ~69–73% (pretreated) • ORR ~73–82% (treatment-naïve) • Durable responses + CNS activity 👉 Replaces MKIs upfront 🧠 RET wild-type MTC 👉 Cabozantinib (EXAM trial) 👉 Vandetanib (ZETA trial) 📊 EXAM → PFS 11.2 vs 4.0 mo ZETA → PFS 30.5 vs 19.3 mo 🧠 After progression 👉 Clinical trial preferred 👉 Switch TKI (cabo ↔ vandetanib) if needed 🧠 Immunotherapy ❌ Not recommended outside trials 🧠 Chemotherapy 👉 Last-line only ⚠️ Big shift Old → Start TKI for all New → RET first → Target → Then TKI 🎯 Takeaway 👉 If you miss RET, you miss the best therapy 🔖 Save this before your next MTC case #OncoTwitter #MedTwitter #ThyroidCancer #MTC #PrecisionOncology @OncoAlert @myesmo @esmo_open @asco

🚨 New ASCO Guidelines: Thyroid Cancer (2026) Not “which drug?” 👉 It’s now “which mutation?” 🧠 Differentiated (RAI-refractory) No mutation → Lenvatinib > Sorafenib Progression → Cabozantinib Mutation → RET → Selpercatinib NTRK → Larotrectinib BRAF → Dabrafenib + Trametinib 🧠 Anaplastic thyroid cancer (ATC) 🔥 BRAF V600E → Dabrafenib + Trametinib = STANDARD No mutation → Lenvatinib ± IO / Ipi+Nivo 🧠 Medullary thyroid cancer (MTC) RET+ → Selpercatinib RET WT → Cabozantinib / Vandetanib ⚠️ What’s changed? 👉 Targeted therapy moves upfront 👉 Immunotherapy mostly out 👉 Chemo = last line 🎯 Takeaway: 👉 Test first. Treat later. 🔖 Save this before your next thyroid OPD 📖 Full paper in comment ⬇️ #OncoTwitter #MedTwitter #ThyroidCancer #PrecisionOncology @OncoAlert @myesmo @esmo_open @asco @JCOPO_ASCO

Important commentary by @USUhealthsci Associate Professor of Surgery @DrDanielleHolt:

Que pésimo servicio el de @MercedesBenzMx @MercedesBenz me venden una camioneta defectuosa y no son buenos ni para avisarme que basado con el proceso … tres veces en taller, más de dos meses en revisión y no se nada, NO LO RECOMIENDO @MercedesBenz

#Mammogram today ✅ Grateful to have access to high quality #cancerScreening. Early detection saves lives. 🧠 Know your family history. 🧠 Know your breast density. 🧠 Know your risk.

Mexican surgical oncologists at #SSO2026!

Let's review #TNT Total Neoadjuvant Treatment and Organ Preservation in #Rectal #Cancers. 1. PRODIGE23 - Induction CT + CRT 2. PROSPECT - No RT & Mid/upper only 3. OPRA - Induction CRT CT Ph2 4. OPERA - Contact Brachy Boost 5. MORPHEUS - HDR BT boost #crcsm #Oncology

@#SSO2026

Liver metastases from uterine sarcoma

New JCO article alert! BRCA + Ovarian Cancer ≠ Same Breast Cancer Risk. After ovarian cancer: 📉 Annual BC risk drops to 0.9% 📉 15-yr risk 11.5% (vs 47% without OC) ⚠️ Only 3 BC deaths 🚫 Routine prophylactic mastectomy not justified. ✅ Prioritize surveillance. Practice-changing perspective. #BRCA #CancerRisk #MedTwitter #Oncology @OncoAlert @DFCI_BreastOnc @oncodaily @breast @ocrahope @ArndtVogel @ASCOPost @JCO_ASCO

Carotid paraganglioma

Goiter

10 days post surgery

I am visiting 📍Barranquilla, Colombia 🇨🇴, where we are participating in a #HOLEP marathon. We will perform 4 cases in 5 hours in the same operating room, for 2 days, 8 cases in total. I believe that the time ⏱️ between surgeries should be optimized as much as possible. This way, it is less tiring and the teaching of the enucleation technique is more replicable. #aeep #epp #proctorship

open.spotify.com/episode/2eVH5U… estuvimos hablando sobre el cáncer de mama …