Luna Acharya, MD MA

An honor to be part of this consensus statement from the @IASLC Advanced Radiation Technology Subcommittee @JTOonline on radiotherapy to the primary tumor in stage IV NSCLC, led by Drs. Ryan McMahon and @_ShankarSiva. Is it time to rethink management of metastatic lung cancer?

How does somatostatin PET perform in detecting nodal metastases in patients with pancreatic NETs evaluated for resection? Not so great... 130 patients w/ pNETs who all had SSTR PET followed by resection. 42% had path proven LN mets but only 24% were seen preop on PET (sensitivity 46%). Specificity much better, 92% with PPV of 81% and NPV of only 29%. As expected, larger nodes and a higher Krenning score were more likely to be found on SSTR PET. Be careful with multifocal pNETs such as in MEN1 as multifocality can resemble nodal mets. @TELL_Starlinger @ThielsCA @PackardAnnie @MayoRadiology @MayoClinicSurg @MayoCancerCare @MayoHemeOnc sciencedirect.com/science/articl…

ASCO GU 2026 – Top 15 Trials with Potential Practice Impact @ASCO #GU26

Whats new and exciting data to look forward in ASCO GU 2026 🙂👇 @ASCO #ASCOGU26 @brunolarvol @MedwatchKate

@GIMedOnc @AnthemBCBS @CarelonRx I had a similar situation. Patients pay premiums for years only to be denied in time of need. This is sad!

Recently, just before starting lifesaving treatment, @AnthemBCBS and @CarelonRx denied immunotherapy for a patient with advanced cancer who is MSI-H and ctDNA-positive—meaning their recurrence risk is extreme. FOLFOX is not an option due to severe neuropathy. Single-agent 5-FU is harmful in this disease subtype. Immunotherapy is the only rational treatment based on NCCN guidelines and phase III published data (ATOMIC). During the peer-to-peer review, the reviewer said: I do not have the authority to approve this based on my guidelines no matter what you say. This is not medicine. This is not quality control. This is insurance blocking evidence-based care in a curative setting. Patients deserve better.

ASCO GI 2026 — what deserves attention 👀 🔴 Late-Breaking Abstracts • ILUSTRO (Shitara et al ): zolbetuximab + mFOLFOX6 + nivo in CLDN18.2+ gastric/GEJ • HERIZON-GEA-01 (Elimova et al ): zanidatamab + chemo ± tislelizumab in HER2+ GEA • LyRICX (Kamp et al ): liposomal irinotecan + platinum ± nivo in 1L esophagogastric ca 🟦 Major General / MDT sessions • Liver Power Hour tumor board (Sanford, Salem) • Liver tumors with dysfunction: control vs hepatotoxicity • Organ preservation in GEJ/gastric cancer • Borderline & locally advanced pancreatic cancer MDT • T2 rectal cancer tumor board 🟢 CRC trials • BREAKWATER (Kopetz): encorafenib + cetuximab + FOLFIRI, BRAF V600E mCRC • COMMIT (Rocha Lima): IO alone vs IO-chemo in dMMR/MSI-H mCRC Theme: less hype, more judgment, sequencing, and multidisciplinary care. #ASCOGI2026 @Larvol @OncoAlert @oncodaily @ASCO

Rounding on the inpatient oncology service this week and I had to go back to this wonderful tweet about @OncoThor’s diagnostic approach to #CUPs (to refresh my memory and also share with my fellow on the service). These are slides from a talk that we were lucky to attend as fellows @UIowaCancer, the most intuitive algorithm and clinically relevant list of IHC markers.

2025 approvals: Summary of 8 new drugs/indications in GU malignancies by @US_FDA 1. #Lu177 2. #Durvalumab 3. #Darolutamide 4. Intravesical #Mitomycyin & #Gemcitabine (TAR200) 5. #Enfortumab + Pembro 6. #Niraparib 7. #Rucaparib #gusm #OncTwitter #MedTwitter

Treatment of cold agglutinin disease #ASH25

GI malignancies drug approvals in 2025 ⬇️ #MedTwitter #onctwitter

@JAMA_current jamanetwork.com/journals/jaman… Findings suggest that adjuvant therapy with exemestane may result in lower disease-free survival and overall survival compared to anastrozole and letrozole.results favor the use of anastrozole or letrozole as initial treatment @OncoAlert

2025 was a true practice-changing year in breast cancer. These #FDA approvals are already changing how we treat patients — not just what we discuss at congresses. #BreastCancer #Oncology

2025 approvals: Summary of 9 new drugs/indications in #LungCancer by @US_FDA 1. #TelisoV 2. #Taletrectinib 3. #DatoDXd 4. #Sunvozertinib 5. #Zongertinib 6. #Lurbinectedin (w/Atezo) 7. #Sevabertinib 8. #Tarlatamab 9. SubQ #Amivantamab #lcsm #OncTwitter #MedTwitter

When I moved to the US in 2021, breast oncology was very different. With 2025 coming to an end, I decided to look back and review 10 major milestones in BC medical oncology care we saw over the past 5 years. With hope and expectation to see so much more unfolding over the next 5!

Check our viewpoint published @JAMA_current #MedEd Abstract Factory—Research Culture Harming Medical Education The "abstract factory" is destroying medical education. Trainees and junior faculty compete with abstract counts instead of meaningful research. Result: inflated CVs, diluted conferences. We shouldn't celebrate this—you don't need publications to be a great doctor. ➡️jamanetwork.com/journals/jama/… @utswcancer @rajshekharucms @HiraSMian @ManniMD1 @HemOncFellows @ASCOTECAG

Rucaparib now fully @US_FDA ✅ in mCRPC chemo naive, BRCA mutated post ARi by - BRCA: mPFS 11.2mos vs 6.4mos. OS 23.2mos vs 21.2 (HR: 0.91) - ATM mutated OS HR: 1.21 - Niraparib also approved recently but in BRCA mCSPC! #ProstateCancer #gusm #OncTwitter

2025: quite a year for ADCs in breast cancer • T-DXd approved for 1L cytotoxic tx of HR+/HER2-low (& #ultralow) MBC • T-DXd now also approved for 1L HER2+ MBC • First ph3 data of T-DXd in the CURATIVE setting • Two TROP2 ADCs replaced 1L SoC in mTNBC Keep ’em coming, 2026🎯

TDXd + Pertuzumab now @US_FDA ✅ in 1L metastatic Her2+ breast cancer based off #DestinyBreast09: vs THP: - mPFS 40.7 vs 26.9mos (HR: 0.56) - 15.2% vs 8.5% CRs - Serious TAES: 27% vs 25.1%. Any Gr ILD 12.1% vs 1%. 2 Gr5 ILDs! #OncTwitter #bcsm @OncoAlert @OncUpdates

#SABCS25 Day 2 Highlights: 1. #lidERA: SERD in Adj HR+ 2. #ALLTO: Adj ET in HR+/HER2+ 3. #ASCENT07: Saci in HR+ mBC 4. #HER2Climb05: Tucatinib in 1L HER2+ mBC 5. #DB11: TDXd in NeoAdj Her2+ 6. #DB05: TDXd in Adj Her2+ @SABCSSanAntonio #bcsm #OncTwitter @OncoAlert 1/7

Herrera et al - 3y FU SWG 1826 - BV-AVD vs Nivo-AVD 1L III/IV Hodgkin - PFS benefit signif: 82% vs 91% - High & low PFS benefit - Particularly striking benefit older pfs (& adolescents) - No myeloid malig in either arm Fantastic data with this regimen #ASH25 #lymsm