Kelly Araujo

"One of the first duties of the physician is to educate the masses not to take medicine." #williamosler😉

Excellent review and discussion of HERIZON-GEA trial 👋

🔄 Refreshed data for COMMIT trial from @ASCO #GI26 in dMMR/MSI-H mCRC landscape from Devang Namjoshi, et al. Original publication: dailynews.ascopubs.org/do/immunothera… Updated Landscape ⬇️ Explore more insights and data from #ASCOGI26 👉 t.ly/_qQqT #LARVOL #Oncology #CancerResearch #CancerData #OncologyInsights #GICancer #GastrointestinalCancer #GICSM | @ArndtVogel | @aparna1024 | @pashtoonkasi | @CathyEngMD | @GIMedOnc

CRITICS-II: multicenter Ph2 RCT in resectable gastric ca showing preop chemo (DOC) + CRT improved 1-yr EFS & pCR (20%) v CRT or chemo alone. But w D-FLOT now SOC, q’s are: 1. Could adding pre-op chemoRT to D-FLOT further improve pCR enabling organ pres option? #GI26 🧵1/2

HERIZON-GEA-01 phs-3: Zanidatamab + CTx +/- Tislelizumab in 1st line Her2+ locally advanced unresectable or mG/GEJ adenocarcinoma #ASCOGI26 👉 ORR: 70 vs 69 vs 65% 👉 mPFS: 12.4 vs 12.4 vs 8.1 mo 👉 mOS: 26.4 vs 24.4 vs 19.2 mo 👉Clinical benefit across PD-L1 subgroups 🧐 convincing data, new SOC?! @myesmo @ASCO

💡 ILUSTRO phase 2 (Cohort 4B): zolbetuximab + mFOLFOX6 + nivolumab in CLDN18.2+ G/GEJ adenocarcinoma #ASCOGI26 🎯 Median PFS: 14.8 months ▪️CLDN18.2-high mPFS 18.0 vs 6.7 mo (intermediate) ▪️CLDN18.2-high & PD-L1 CPS ≥1: mPFS 23.6 mo 💥ORR: 62.1% overall; 68.1% in CLDN18.2-high ✅ Safety and tolerability acceptable Results ILLUMINATES phase 3 LUCERNA design 💡 @OncoAlert #OncoAlertAF @OncoReporte @myESMO @ASCO @_SEOM @GrupoTTD

CARES-009: Perioperative camrelizumab plus rivoceranib in resectable hepatocellular carcinoma #ESMO25 #ESMOAmbassadors 👉 EFS: 42 vs 19 mo 👉 DFS: 42 vs 19 mo 👉 MPR: 35 vs 7% 🧐Very promising results, neoadjuvant strategies will be the future in HCC @myesmo @EASLedu @ilca

📢INTEGRATE II-b Upper GI proffered #ESMO25 ➡️Previosly treated (≥2 prior lines) met. gastric/GEJ ➡️Regorafenib-nivo vs ChT ❌Negative trial #cancer #oncology #MedX #GI #gastrointestinal @OncoAlert @OncoReporte

Invited Discussant LBA81 and 2094O Sylvie Lorenzen #ESMO25 #ESMOAmbassadors 👉Durvalumab improves pCT & MPR in resectable G/ GEJ adenocarcinoma, significant and clinical benefit @myESMO

Holy smokes, MATTERHORN hits OS! 🏔️🔥 We’ve been waiting for this one. After FLOT became standard for resectable gastric and GEJ adenocarcinoma, everyone wondered if adding immunotherapy could move the bar. Earlier this year, MATTERHORN showed a big EFS win for DFLOT, along with higher pCR and MPR rates, but the question was, would OS follow (and yes, maybe I was doubting this)? Now we have the answer: 🧬 OS HR 0.78 (95% CI 0.63–0.96, p=0.021) A clean, statistically significant win. 💪 Benefit seen across PD-L1 subgroups (TAP <1% HR 0.79; TAP ≥1% HR 0.79). 🧫 More nodal downstaging: ypN– 58% vs 45%, OR 1.72 (1.30–2.27). ⏱️ EFS improved in those with pCR (HR 0.29) and MPR (HR 0.32). Takeaway: Perioperative chemoimmunotherapy is here for gastric and GEJ adenocarcinoma. MATTERHORN delivers the OS confirmation we needed and cements DFLOT as standard of care (we can argue about PD1 +/- later). @OncoAlert @GutOncLab #ESMO25 🧬💥

MATTERHORN #ESMO25 – LBA81 Durvalumab + FLOT becomes the first peri-operative immunotherapy regimen to show an overall survival benefit in resectable gastric/GEJ cancer. Viewed alongside the #ASCO25 interim (EFS, pCR) results, the final OS data complete the picture — consolidating Durvalumab + FLOT as a potential new standard of care. #MATTERHORN #Durvalumab #FLOT #GastricCancer #Immunotherapy #Oncology #ClinicalTrials @CParkMD @tugbawitter @Dr_ElvinaA @atakansare2016 @drmukremin @dr_yakupergun

MATTERHORN: Phase III study of durvalumab + FLOT in resectable G / GEJ adenocarcinoma #ESMO25 #ESMOAmbassadors 👉 pCR: 16%, MPR: 26%, any: 87% 👉 OS: HR: 0.78; 36-mo OS: 68 vs 61% 🧐OS improved independent of TAP, better in responders > new SOC @myesmo

Advanced HER2-negative gastric/GEJ cancer 💉 QoL KEYNOTE-859: pembrolizumab + chemotherapy vs. placebo + chemotherapy 📈 Improved survival ⚖️ Maintained quality of life ➡️ Benefits in CPS ≥1 & ≥10 ✅ first-line option in HER2-negative gastric/GEJ 🔗 doi.org/10.1016/j.ejca…

Always think beyond the stomach: H. pylori may worsen systemic diseases @AGA_Gastro @MayoClinicFLGIH 🦠 Helicobacter pylori and Extragastric Diseases – Clinical Pearls 🔑 Key Insights H. pylori is the world’s most common pathogen, beyond gastric ulcers & cancer, it has unignorable extragastric impacts. Links established with COVID-19, atherosclerosis, hyperemesis gravidarum. Under investigation: GERD, asthma, IBD. ⚙️ Pathogenic Mechanisms Chronic systemic inflammation 🧯 Continuous immune activation → multi-organ effects. Molecular mimicry 🎭 Cross-reactive antigens → autoimmune pathways. Gut microbiome disturbance 🌱 ↓ Lactobacillus spp. ↑ E. coli, Bacteroides/Prevotella, Enterococcus spp. Increased α-diversity but dysfunctional balance. Immune-metabolic consequences Hypochlorhydria + hypergastrinemia → dysbiosis. Dysbiosis → immune imbalance, insulin resistance, diabetes, NAFLD, abnormal lipid metabolism. 💡 Clinical Pearls ✅ Always think beyond the stomach: H. pylori may worsen systemic diseases. ✅ Gut dysbiosis links H. pylori to metabolic syndrome & NAFLD. ✅ Persistent infection = higher pro-inflammatory milieu → ↑ risk of atherosclerosis. ✅ Watch for pregnancy complication link: H. pylori in hyperemesis gravidarum. ✅ Emerging associations: COVID-19 severity, asthma modulation, IBD. ✅ Eradication therapy may have benefits beyond GI tract → a potential systemic preventive strategy. 📌 Take Home Message H. pylori infection is not only a gastric pathogen but also a systemic disruptor — via inflammation, immune mimicry, and microbiome disturbance. Future management may consider screening and eradication in patients with unexplained extragastric diseases. frontiersin.org/journals/micro…

Two important randomized trials in #PancreaticCancer published: 1st PASS-01 in metastatic cancer comparing FOLFIRINOX to Gem/Abraxane (@JCO_ASCO) 2nd PREOPANC-2 in resectable/borderline resectable cancer comparing neoadjuvant FFX versus Gem/CRT (@TheLancetOncol) @OncoAlert ⬇️

🚨 PRRT moves upfront in high-grade NETs? 🔥 📝 Cancers 2025 | Review on G2/G3 GEP-NET sequencing 🔑 Essentials •G2 (Ki-67 10–20%) & G3 (Ki-67 20–55%) NETs = no clear SoC • Most regimens extrapolated from low-grade NETs • 🔎 [68Ga]Ga-DOTA PET = baseline must-have • 🔀 Dual SSTR + FDG PET = key for selection 💉 Therapy sequencing • 1L: 💡 Consider PRRT in SSTR+ stable pts • 🧴 SSA → low-volume, indolent cases • 💊 Chemo (CAPTEM, platinum, FOLFOX/FOLFIRI) → visceral crisis/rapid disease • 🎯 TKIs (cabozantinib, sunitinib) & mTORi (everolimus) → later lines 📊 NETTER-2 trial • 1L [177Lu]Lu-DOTATATE → mPFS 22.8 mo vs 8.5 (HR 0.27) • ORR 43% (↑ in G3, esp. pancreatic NETs) 💡 Takeaway PRRT could redefine 1L care in well-differentiated G2/G3 NETs — guideline updates may be coming soon! 🚀 📖 Chauhan A, Halfdanarson TR, Vijayvergia N. Cancers. 2025. 🔗DOI: doi.org/10.3390/cancer… #OncoTwitter #MedTwitter #NeuroendocrineTumors #PRRT @OncoAlert @ASCO @myesmo @esmo_open @cancers_mdpi

➡️433 pts from 5 centers were re-irradiated for prostate cancer. ➡️64.2 % and 90.3 % : NO acute toxicity. No treatment-related deaths. LateG2 or G3 GU tox in 16.2 and 4.8 %. ➡️With a median F-up of 54 months biochemical recurrences was 55.2 % 👉pubmed.ncbi.nlm.nih.gov/40953707/

Total Neoadjuvant Therapy for Rectal Cancer: Which Regimens to Use? pubmed.ncbi.nlm.nih.gov/38893212/

🔥now fully published: Five-year overall survival update from the HIMALAYA study of tremelimumab plus durvalumab in unresectable HCC @JHepatology doi.org/10.1016/j.jhep… ✅"long-term" survival in HCC, we are getting there @myESMO @EASLedu @ILCAnews

A study led by @MayoClinic clinicians shows that neoadjuvant chemotherapy (NAC) improves 5-year survival in locally advanced #ColonCancer. Analysis of 8 control trials supports NAC as a safe, effective alternative with high-quality evidence. Learn more: bit.ly/4mhoTVB

NIVO + IPI vs NIVO for MSI-H/dMMR mCRC: Health-related quality of life analysis 🔎CheckMate 8HW 👉mPFS clearly improved 👉 HRQoL, less symptoms 🧐 Supports use of Nivo IPI as 1st line treatment in MSI CRC #ESMOAmbassadors #ESMOGI25 @myESMO