Jenny Seligmann

Thanks for all the positive messages re FOCUS4C. Beyond delighted to see this in ⁦@guardian⁩ theguardian.com/society/2021/s…

👏👏👏 FOxTROT 5 testing peri-op dostarlimab in MSI-H locally advanced colon cancer in older or frail patients. Thanks to our fantastic 🇬🇧 investigators. FOxTROT 6 to follow soon…. @yorkshirecancer @adbeggs @JenSeligmann @LTHTResearch

Jordan Appleyard Presents HER3 Analysis from FOxTROT Trial at ASCO GI - @JenSeligmann oncodaily.com/voices/jenny-s… #Cancer #ASCOGI26 #OncoDaily #Oncology #MedEd #MedTwitter #MedX #MedOnc @CancerWorldmag

🆕Article of the Month podcast🎧: @tompowles1 discusses the FOxTROT trial in locally advanced colon cancer with @JenSeligmann tinyurl.com/2sv3eyf4 For the full study report see: doi.org/10.1016/j.anno…

#ESMO25 @myESMO A pleasure to join this symposium with @JenSeligmann & Julien Taieb ➡️ more choices in refractory mCRC ✅ ➡️ needs a tailored approach to optimize tx @TakedaOncology @myESMO #ESMOAmbassador

@GIMedOnc @nicholasklemen Absolutely this! Give them the chance to decide!!

You get the most bang for your buck from IO in the neoadjuavnt (or non-op) setting. You’re reducing your current fraction based on potential toxicities… up to patients to decide, but weighing real toxicities versus dying from cancer is the question here (not side effects of immunotherapy vs surgery).

NICHE-2 absolutely delivers. Game over for chemo in dMMR colon cancer 💥🧬 In locally advanced dMMR colon cancer, FOxTROT already showed us chemo doesn’t work, and now NICHE-2 makes it undeniable. 💊 Neoadjuvant nivolumab + ipilimumab → • 99% pathologic response • 67% pathologic CR • Zero recurrences to date at 3 years 🪦 This is the final coffin nail for perioperative chemotherapy in this setting. ATOMIC is already on life support despite being published less than a year ago. The real question now: with Cercek’s rectal data, can we safely omit surgery next? At minimum, this should be the new standard. At maximum, it’s the start of a paradigm shift. @OncoAlert @TheGutOncLab #ESMO25

Neoadjuvant IO for locally advanced MSS colon ca…. This article helps us take a further step forward by demonstrating clear efficacy and signals towards biomarkers for pt selection. 💥💥huge congrats to my team neoadjuvant dear friend and team! We will get there in colon cancer

@aparna1024 Ah…the FOxTROT and NICHE-2 teams are working on the staging and identification of high risk pt at baseline. With disappointing DYNAMIC-3 results and clear disadvantage for T4 pts the need is clear! As you say presenting option to pt key

Yet, question still remains in the era of suboptimal staging, over treatment with NICHE and in era of ATOMIC, except for T4, should we operate first? That being said, I am generally in the NICHE camp and believe every pt w/ MSI-h colon has to at least have med onc conversation!

@nicholasklemen @GIMedOnc Good points. My views… We’ll be trialling NOM with strict surveillance schedule akin to rectal in FOxTROT 6. Await recurrence strategy - 50% will not be cured. Best to treat optimally in curative setting but concede risk of tox esp long term endocrinopathies

@GIMedOnc Some thoughts: 1. Agree surg may be omitted. Recurrence after CR rare based on trials in other stg IV cancers. 2. Toxicity of ipi/nivo is real. Balance of surg first and IO for recurrence, vs neoadjuv approach? 3. Surveillance schedule for non-op colon? Q6mo x3y seems reasonable.

@smitha42 Thanks - especially with point that this option should be discussed! Marked benefit with T4 regardless of N stage

cT3/T4 per CT identifies patients with dMMR colon cancer with substantial risk of recurrence despite FOLFOX: cT3N0: 84% 3-year DFS cT4N0: 70% 3-year DFS Of course, NICHE2 : 100% 3-year DFS for cT3/4 For patients with dMMR colon cancer cT3/T4 by CT: we should discuss risks and benefits of neoadjuvant IO vs surgery and adjuvant therapy. We should recommend neoadjuvant IO for cT4N0.

@RenoHemonc Good question. Issue is nodal staging in MSI-H pts. Trust T stage more! For me >15% relapse vs 0% with IO. I think this is meaningful & should be discussed with pts

@JenSeligmann T3N0 qualifies ? Current nccn recommend t4 or N+

Proud to present combined NICHE-2 & FOXTROT analysis in dMMR locally advanced CC -Neoadjuvant IO superior to chemo -20% relapses with chemo in "good prognosis" group; 30% if T4 -Minimal path response to chemo - Clinical staging identified high risk group

My take homes.... Further support of neoadjuvant IO esp for high risk pts Chemo no or limited role for dMMR early CC (?ATOMIC strategy) Clinical staging CAN identify high risk pts 20% recurrence relevant when effective rx available! @MyriamChalabi @CRUKresearch @oncodaily

Thanks for highlighting!! @MyriamChalabi

@MyriamChalabi @Nature @myESMO @NKI_nl @DrChoueiri @HaanenJohn @NFdeMiranda @Schumacher_lab Cant wait to read this!!!

Very proud and happy to share that our work on neoadjuvant IO in pMMR colon cancers has been published online in @Nature after presentation @myESMO #ESMO25. Preview: rdcu.be/eLTN1 Read on how genomic instability, P53mt and proliferation may aid in predicting responses.

Durvalumab & tremelimumab + local partial tumour ablation in pts with unresectable liver mts from mCRC: results of the EORTC-1560-GITCG ph II study (ILOC) in @ESMO_Open. No benefit with ICIs combination in this pts group with high therapeutic unmet need. esmoopen.com/article/S2059-…

@adbeggs @FoxtrotStudy @chrisjmwilliams @OncoAlert @LIMRLeeds

🤔Pani had little effect on path response 👍Prospective trial in LACC RAS/RAF-wt EREG/AREG pts planned ❓Consider in LARC This will be my last tweet - hope to see you on Bluesky 👋 @b

🎆 Now online - my 2 fav topics in one paper 👍FOxTROT Ph2 FOLFOX+/- pani in locally advanced RAS/RAF-wt colon cancer 👍Convincing activity of anti-EGFR on long term outcomes, esp in hyperselected pts ❓Time to re-think targeted agents in LACC/LARC annalsofoncology.org/article/S0923-…

Just finished. Very interesting #MiniOral #ESMOAsia24 session in #PDAC and #Biliary that I had the pleasure to co-chair (and discuss) with @JenSeligmann Posts coming with my thoughts 😉 Thanks @LorenzaRimassa for the 📸 🫶 @myESMO

Check out our editorial on high-risk stage II colon cancer: a call for clinicians to exercise caution when withdrawing oxaliplatin and when interpreting subanalyses sciencedirect.com/science/articl… @DrClaireGallois @JenSeligmann