Javier Melchor-Ruan

FDA grants early access to pancreatic cancer drug daraxonrasib usatoday.com/story/money/20…

PARP inhibitors in BRCA/PALB2-mutated PDAC show durable benefit in a subset: • ORR: 41.6% • Median PFS: 12.8 mo | OS: 24.3 mo • ~17% achieved >5-year PFS (median ~75 mo) Long-term responders: mostly BRCA2, low tumor burden, no resistance mutations Resistance in ~50%; MDS/AML ~5% @Larvol @OncoAlert #cancer

Pancreatic cancer has one of the most suppressive tumor microenvironments in oncology. But two pancreatic cancer results dropped today. Both matter. 1. BioNTech mRNA neoantigen vaccine: nearly all responders still alive at 6 years. 98% of induced T cells were de novo — the immune system learned to see a cancer it had always been blind to. 2. Daraxonrasib: 47% ORR, 92% disease control as first-line monotherapy. KRAS G12D, undruggable for 40 years, finally has a drug. Different mechanisms. Same disease. Both working. <13% of patients survive 5 years. That number is about to change. great day for science! 🔥

A Mayo Clinic-developed artificial intelligence (AI) model can help specialists detect pancreatic cancer on routine abdominal CT scans up to three years before clinical diagnosis. It identifies subtle signs of disease before tumors are visible, when curative treatment may still be possible. The findings, published in Gut, mark a milestone in Mayo Clinic's multiyear research effort to enable earlier detection of one of the deadliest cancers. Learn more: mayocl.in/4eippBP

Nuestro especialista, el Dr. Javier Melchor Ruan, participó en La Hora Nacional hablando sobre cáncer colorrectal. Te invitamos a escuchar su intervención y conocer información clave sobre prevención, detección oportuna y tratamiento. ¡Infórmate y comparte!

¿Sabías qué?🤔 El cáncer de colon es altamente curable si se detecta a tiempo mediante pruebas de cribado como la colonoscopia. 🎥Este próximo domingo en nuestro programa nos acompañará el Dr. Javier Melchor Ruán, cirujano oncólogo y jefe del Departamento de Gastroenterología del Instituto Nacional de Cancerología, quien nos explicará cómo prevenir esta enfermedad, cuidados y tratamientos.👨🏻‍⚕️ ✅️Infórmate mañana a las 10 de la noche. 📺

Adjuvant chemotherapy works in colorectal cancer… right? 🤔 When it comes to resectable colorectal liver metastases, the answer may be more complicated than we like to admit. JCOG0603 was the first randomized trial to test adjuvant doublet chemotherapy after hepatectomy in CRLM. The headline result was familiar: adjuvant mFOLFOX6 improved disease free survival. But with long term follow up, overall survival has told a different story. There was no OS benefit compared with surgery alone, despite years of additional follow up. This mirrors what we have already seen with EORTC 40983 and New EPOC. Why the disconnect? • The trial was powered for DFS, not OS • Oxaliplatin alters liver parenchyma, making CT based DFS a potentially unreliable surrogate • Patients in the surgery only arm had more effective salvage surgery and greater reuse of oxaliplatin at recurrence • Toxicity mattered, with high rates of severe neutropenia, poor chemotherapy completion, and even rare treatment related death The bigger lesson is uncomfortable but important. In resectable colorectal liver metastases, delaying radiographic recurrence does not necessarily translate into living longer or living better. Post recurrence management, surgical salvage, and tumor biology may matter far more than perioperative chemotherapy intensity. For me, this argues against routine adjuvant mFOLFOX after hepatectomy and toward more selective, biology driven decision making 🧬 At the same time, this is not an easy “don’t treat” scenario. We lack clearly superior alternatives, and choosing not to give systemic therapy in a high risk disease is hard for clinicians and patients alike. If anything, JCOG0603 highlights the real unmet need in CRLM: better studies, better biomarkers, and better drugs. This disease keeps surprising us, and this is one of the most important reminders why. @OncoAlert @TheGutOncLab ascopubs.org/doi/10.1200/JC…

🆕 Article in @JCO_ASCO 🚨 Adjuvant mFOLFOX6 after hepatectomy for colorectal liver metastases – JCOG0603 long-term OS results 🚨 📚 Randomized Phase II/III trial 👥 300 patients with colorectal adenocarcinoma and liver-only metastases (unlimited number) 💊 Adjuvant mFOLFOX6 after hepatectomy ⚖️ Hepatectomy alone ⏳ Median follow-up: 7.7 years for disease-free survivors 📊 Results: 📈 5-year DFS: 49.7% (adjuvant chemo) vs 40.5% (surgery alone) 📉 DFS HR = 0.72 (95% CI, 0.54 to 0.97) ✅ 📈 5-year OS: 73.4% (adjuvant chemo) vs 80.1% (surgery alone) 📉 OS HR = 1.07 (95% CI, 0.73 to 1.57) ❌ ⚠️ Toxicity: One possible treatment-related death in adjuvant arm; one post-protocol complication death in surgery arm. 💡 Adjuvant mFOLFOX6 improved DFS but did not translate into a long-term overall survival benefit. #ColorectalCancer #LiverMetastases #Hepatectomy #AdjuvantChemotherapy #mFOLFOX6 #MedTwitter #PubXelProject PMID:41564372 pubmed.ncbi.nlm.nih.gov/41564372/

This commentary observes that the disappearance of colorectal liver metastases on imaging does not reliably signify nonviability, emphasizing the need for cautious patient management and advanced diagnostic tools. ajronline.org/doi/10.2214/AJ…

New online! Cholangiocarcinoma 2026: status quo, unmet needs and priorities bit.ly/4q14llS

🔴 #EnVivo || ¿Cómo se pueden prevenir los casos de cáncer de hígado? Escucha al Dr. Javier Melchor Ruan, Jefe del Departamento de Gastroenterología del @incanMX. ▶️: bit.ly/4bXR4U4

How do costs of robot 🤖 vs open pancreatoduodenectomy compare? Will costs become similar over time? 588 pts A’dam 🇳🇱 (214 RPD, 374 OPD) ⛔️Overall, costs €4,804 ⬆️ for RPD (€27,307 vs. €22,503, P=0.010) ✅Outcomes RPD improved in the 2nd half experience (n=107): hospital stay 3 dys⬇️, pancreatic fistula 16%⬇️, DGE 18%⬇️, operative time 63’⬇️ etc ✅ Hence, costs RPD⬇️: in the 2nd half €11,058 less (!!) vs 1st half RPD 🔑 Costs in the 2nd half RPD vs OPD comparable (€21,778 vs. €21,013) while RPD associated with shorter stay, less DGE, less wound infection, less blood loss ✅DIPLOMA-2 coming up….. ▶️journals.lww.com/annalsofsurger… #pancreaticcancer #surgery #Whipple

What’s New and Interesting at Annals: Cost-analysis of implementing robot-assisted versus open pancreatoduodenectomy from @julia_menso @MichielFrancken @MarcBesselink @AmsterdamUMC #roboticsurgery #roboticpancreatoduodenectomy #costanalysis journals.lww.com/annalsofsurger…

#GI25 highlights #CommunityOnc: 1. #SCIENCE: Adv Eso SCC 2. #ESOPEC publication (Eso/GEJ/Ga) 3. Chemo in resectable Panc Ca 4. #StarterNET: GEP-NET 5. #CM8HW: dMMR/MSI-H mCRC 6. #BREAKWATER: BRAFV600E mCRC 7. ctDNA: #BESPOKE + SWOG80702 #OncTwitter #gism @ASCO 1/8

Fantastic discussions and talks on Gastroesophageal Cancer at @incanMX with national and international speakers. Great opportunities for collaboration and translational applications to fight this disease in LATAM and worldwide. @MichausSalais @draivs

We’re thrilled to host an international event focused on gastric cancer, bringing together leading experts and groundbreaking discussions! October 4th, 2024 at @incanMX @YJanjigianMD @FlorianLordick @Juanmaoconnor @DrGarridoOncoGI @BallenDF @DrLeTk

Unidad Funcional y plan de trabajo en el área de Tumores de Tubo Digestivo del @incanMX por nuestro Jefe de Servicio @MelchorMD Mucho camino recorrido y mucho más por recorrer para alcanzar la excelencia en el manejo de nuestros pacientes @SMINCan @docenciaincan

En la lucha contra el cáncer, no hay lugar para la desigualdad. En México, quienes viven en zonas marginadas enfrentan mayores desafíos. Con la #LeyGeneralDeCáncerMx 🇲🇽 podemos cambiar esta historia y asegurar un acceso equitativo a tratamientos.

Hot topic 🔥 Robot vs. Open Pancreatoduodenetomy on @LancetGastroHep RCT 🇨🇳 164 pts - at least 40 robot PD performed Hospital stay days 🤖 11 vs. 13 🔪 Readmission / mortality 🙅‍♂️ same 🤔Outcome interpretation ?! Comments?! 🫵 thelancet.com/journals/langa…

Y toda colaboración da buenos resultados.

Formamos parte de tres grandes instituciones @incmnszmx @HGM_OD @incanMX, hicimos eco a la iniciativa del Dr. Carlos Chan . 11 años después tenemos una @amhpb_mx Asociación sólida, consolidada que agrupa a cirujanos de hígado, páncreas y vías biliares de todo el país …