Ramesh Pandey

Neurosurgery- Fresh off the press journals.lww.com/neurosurgery/f…

🔍 PSA can stay quiet while cancer progresses. New ENZAMET post-hoc analysis shows radiographic progression without PSA rise in mHSPC is real, common, and dangerous. 🧪 Study essentials •Retrospective analysis of ENZAMET (ANZUP 1304) •n = 1125 mHSPC patients •Enzalutamide vs standard NSAA ± docetaxel 📊 Key findings •Discordant progression (DP) in 10% overall •Accounts for ~30% of all progression events •5-yr OS: 24% (DP) vs 42% (other progression) •Enzalutamide delayed DP (HR 0.66) and OP (HR 0.37) 🧠 Clinical takeaway •PSA alone is not enough •DP carries worse survival irrespective of treatment •Supports regular scheduled imaging, not only PSA-triggered scans ⚠️ Why it matters •Silent radiographic progression risks late treatment switch •Highlights biological heterogeneity in mHSPC 📌 Bottom line In mHSPC, no PSA rise ≠ no progression. Imaging needs to stay proactive. 🔖 Save for clinic 📖 Full paper in comment ⬇️ #OncoTwitter #MedTwitter #ProstateCancer #mHSPC @OncoAlert @myesmo @esmo_open @asco

🔴Online now: Ultra-hypofractionated versus conventionally fractionated radiotherapy for localised #prostatecancer (HYPO-RT-PC): 10-year outcomes of an open-label, randomised, phase 3, non-inferiority trial thelancet.com/journals/lanon…

Check out the latest recommendations for contouring low-grade gliomas – with practical insights on volumes, OARs, and imaging integration. A must-read for clinical practice and planning optimization. #RadOnc #NeuroOncology #Contouring #RTplanning ⬇️⬇️⬇️ thegreenjournal.com/article/S0167-…

Prostate cancer & the heart 📊Over 1M men are diagnosed with prostate cancer annually. ❤️ Cardiovascular disease (CVD) is the leading non-cancer cause of death in these patients. ⚠️ Androgen deprivation therapy (ADT), a mainstay in treatment, increases risks: ▪️ Hypertension ▪️ Diabetes ▪️ Myocardial infarction ▪️ Stroke What we should do? 1.Recognize CV risks before starting ADT 2.Promote “Life’s Essential 8” from @American_Heart ▫️ Healthy diet ▫️ Exercise ▫️ Sleep ▫️ Tobacco cessation ▫️ Weight, BP, cholesterol, glucose control 🩺Clinical insight: The PRONOUNCE trial explored CV safety of GnRH antagonist vs. agonist—findings are inconclusive due to early termination. More robust cardio-oncology research is needed! 💪Call to action: Collaborate across specialties, cardiologists, oncologists, urologist, for shared decisions and better outcomes. pubmed.ncbi.nlm.nih.gov/40155990/

Hypo-fractionated RT at 45 Gy in 15 FX with concurrent chemo is not inferior to 60 Gy in 30 FX in limited-stage small cell lung ca for OS and PFS. Hematological toxicity is less in 15 FX. This opens the door for hypofractionated RT with chemo in modern era using IMRT. #WCLC2025

📢 STORM trial breaking results at #ESTRO25! 🧪 MDT vs ENRT+MDT for nodal oligorecurrent PCa. 🧬 ENRT+MDT: ✅ Superior bRFS (57% vs 41%, p=0.014) ✅ Superior pelvic control (lrRFS 85% vs 62%, p=0.006) ✅ Superior MFS (76% vs 63%, p=0.06) ❌ No increase in ≥G2 GU/GI toxicity

Pleased to share the primary endpoint analysis of the LUNAR trial out in @JCO_ASCO ascopubs.org/doi/10.1200/JC…. The addition of 177Lu-PNT2002 to SBRT improved PFS and HT-FS over SBRT alone, without a significant increase in toxicity, in men with oligometastatic prostate cancer

ESMO-ESTRO consensus on the safety of combining radiotherapy with ICIs, VEGFi, or multi-TKIs @Annals_Oncology In GI field (thorax, abdomen, or pelvis) ✅PD-(L)1: minor/no adaptation ✅CTLA-4: major adaptations with high-dose RT ✅VEGFi: major adaptations ✅TKI: major adaptations sciencedirect.com/science/articl… @OncoAlert @oncodaily

@SeanPitroda Thanks for sharing @SeanPitroda How RT induces YTHDF2 in dendritic cells, possibly then causing the treatment failures and metastases. What are your next steps? Do you have a intervention study planned?

6/ Takeaway: RT induces YTHDF2 in DCs, which suppresses antigen presentation and limits systemic antitumor immunity. Targeting YTHDF2 is a promising strategy to enhance RT + immune therapy and improve metastatic control. 🔗rupress.org/jem/article/22…

1/ New paper 🚨 Radiotherapy (RT) can activate antitumor immunity — but it can also impact metastatic spread in ways we don’t fully understand. In our new study, we identify a radiation-induced immune checkpoint in dendritic cells (DCs) that limits CD8⁺ T cell priming.

Important data to inform pelvic RT fields in invasive bladder cancer..for bladder preservation for advanced stages and post-op RT too! Higher T stage and tumor grade ➡️ high nodal involvement. @VedangMurthy @PaulSargos @Xristodouleas

@SimonLo21054188 @RANZCRcollege What an amazing ASM program @RANZCRcollege. Well done organizers @weeloonong. So good to catch up with good friends @SimonLo21054188 and meet new ones.

⁦⁦@Ramesh_Pandey_⁩ It’s lovely to see you ⁦@RANZCRcollege⁩ 2025!

@ranzcr Asm 2025 Melbourne with @SimonLo21054188

72 pts with GBM in a prospective study had integrated oncology meds + Stupp protocol, had double median survival,  OS 25.4 mths, (34.4 mths if GTR), cf to 10.6 mths without integrated oncology meds. Boswelic, Curcurmin and Polydactin. pmc.ncbi.nlm.nih.gov/articles/PMC12…

🧬🔍: Can a single blood test screen for multiple cancers? In this must-read review from Nature Reviews Clinical Oncology, authors dive deep into the current state and future directions of MCED (Multi-Cancer Early Detection) via liquid biopsy! 🧪🩸 🎯 Key Takeaways: • MCED via liquid biopsy offers a non-invasive, scalable screening tool 🧫 • Methylation-based assays are leading the way in sensitivity & specificity 🧠 • Analytical performance remains a barrier to routine implementation ⚠️ • Trials like NHS-Galleri will be crucial in validating clinical impact 📊 • Future focus: Earlier detection 🕰️ + more effective treatments 💊 = better outcomes ✅ 💡 ISLB members & researchers: Stay ahead of the curve in early detection science! 📖 Read the full article: nature.com/articles/s4157… @ChristianRolfo @ElJanLe @DrYukselUrun @UmbertoMalapel1 @ErulEnes @RobertoBoreaMD @drgandara @MJOSESERRANO19 #LiquidBiopsy #MCED #ISLB #CancerScreening #PrecisionOncology #ctDNA

@jryckman3 @davcmed @DrAndrewLoblaw @cristian_udo @krishnan_patel Looks like we beat you to it Drew! 😀 PSMA-PET, MRI, DIL, SBRT, toxicity, The works! pubmed.ncbi.nlm.nih.gov/40158732/

I’m excited to share that our publication of the first modern American case series for the treatment of Osteoarthritis (OA) with Low Dose Radiotherapy (LDRT) is now published and available online in the red journal. The American patient population differs significantly from European and Asian populations in terms of obesity prevalence, dietary patterns, and lifestyle factors. This paper is the first of its kind to report an American patient population treated with LDRT utilizing modern field design, dosing, and treatment schedules allowing for a second course. I would like to thank @WilliamSmallJr and @DrRShaffer for their guidance. Our program at FHN has now treated over 250 OA patients over the past 2 years. I’m inspired everyday by the impact LDRT has done for our community and patients. Article link: redjournal.org/article/S0360-…

Prophylactic radiation therapy to the contralateral breast in BRCA1/2 mutation carriers with early breast cancer significantly the onset of contralateral breast cancer compared to surveillance alone. ja.ma/436lWiu

📢🧬Our study on SGLT2 and papillary RCC has been published! @myESMO @OncologyAdvance ➡️SGLT2 inhibitors dramatically changed the treatment of diabetes, heart failure and chronic kidney disease ❗️SGLT2 is selectively expressed in kidney ✅Our study suggest SGLT2 may be a potential biomarker and target in papillary RCC, calling for further studies 👉doi.org/10.1016/j.clgc… @DrYukselUrun @yekeduz_emre @DanaFarber_GU @OncoAlert @weoncologists #cancer #Oncology #MedX

More data that IR thermal ablation is inferior to surgery/radiation At 5 years, the change in mean eGFR from baseline was –10·85 mL/min SBRT, –12·25 mL/min for RFA, and –13·35 mL/min for cryoablation (p=0·75) Time to pull the plug on TA