Rubab Aftab

For rad oncs taking oral boards soon, here is a video I made a year ago to help prep for the GI section. Good luck🍀! m.youtube.com/watch?v=G157j6…

@MrinankSharma You don't ever let go off the thread..very beautiful! All the best for the unseen and the unknown.

Today is my last day at Anthropic. I resigned. Here is the letter I shared with my colleagues, explaining my decision.

Oncology fellows (med/rad/surg) & early career faculty interested in learning more re: manuscript publication process - consider applying to the JCO Editorials Fellowship! More info & link to apply below. Due Feb 26. ascopubs.org/fellowship @JCO_ASCO @ASCO

Very concept-clearing video on high-risk prostate cancer by @NicholasZaorsky. Clear structure, practical framing, and very well explained. A must-watch for registrars and fellows.

First prospective series to demonstrate #SBRT could induce contralateral lobe hypertrophy in #HCC - Around 30% increase in FLR - Fastest rate in first 3 months - Ongoing hypertrophy until plateauing at 12 months Full text link: redjournal.org/article/S0360-…

Link to whole video is here 2/5. youtube.com/watch?v=C5_shJ…

Here's something in writing on the topic. Feedback welcome Routine post-radiation biopsies rarely predict control across solid tumors and should only be done when recurrence is truly suspected. Residual cells often represent senescence after radiotherapy, not necessarily recurrence.   ACT II (anal squamous cell carcinoma) illustrates the core principle, as anal SCC frequently shows continuous regression after chemoradiation. Many patients with “residual” disease at around 3 months convert to complete response by around 6 months, which reflects biology and post-radiotherapy response timeframe, not insufficient treatment. Biopsies at 3 months label potentially curable patients as “persistent disease,” despite being mid-course in a normal radiotherapy regression process.   Across many solid tumors treated with radiotherapy, post-treatment biopsy does not reliably predict local control or metastatic risk. Residual cells after radiotherapy are not equivalent to active cancer. 1.        Prostate cancer: PSA may never reach zero after RT-alone approaches. Detectable PSA or small foci of cancer cells can persist, but may be senescent or non-proliferative. Further, biopsy positivity does not predict local failure or metastases. One of the most meaningful signals in follow up is sustained PSA rise. Early “positive” biopsy (first 12-24 months) often fails to correlate with true failure; therefore, routine post-treatment biopsies were abandoned. 2.        Renal cell after SABR: Guidelines explicitly discourage routine post-SABR biopsy because a positive biopsy does not predict local or distant outcomes. 3.        Other SCC sites (H&N, lung): early biopsy frequently reflects treatment effect, necrosis, inflammation, or senescent tumor cells rather than viable cancer.   Why senescence matters clinically:                   Radiotherapy induces: Mitotic catastrophe, permanent cell-cycle arrest, senescence-associated secretory states, delayed apoptosis.                   Residual cells may be present on biopsy, imaging, or biomarker assays, yet be: non-clonogenic, unable to divide, and irrelevant to long-term control.                   This explains: Persistant PSA after prostate RT without PSA progression, persistent radiographic masses after lung or RCC SABR without regrowth, and persistant mucosal irregularities after anal CRT that eventually resolve.                   Presence is not proliferation, and proliferation, not presence, is what determinate recurrence. The harm of routine post-RT biopsy Routine post-RT biopsy creates avoidable harm and no meaningful prognostic value without clinical suspicion of recurrence: 1.        Physical harm: pain, bleeding, infection, poor healing in irradiated tissue, risk of strictures, fistula, or even death (Coradetti NEJM). 2.        Psychological harm: False alarms. Premature “you still have cancer” messaging when the patient may be in remission, especially relevant in cases where a positive biopsy does not predict local or distant outcomes. 3.        Cascade harm: Unnecessary interventions. Triggers unnecessary salvage procedures (e.g., APR, neck dissection, salvage prostatectomy) based on misleading early result. Practical rule across solid tumors Do not biopsy radiated tissues unless there is a real index of suspicion for recurrence, defined by: ·      Progressive findings on imaging, ·      Sustained upward biomarker trend (not fluctuation), ·      New or worsening symptoms, ·      Or a clinical decision point where tissue will change management Routine biopsy, regardless of timing or tumor type, is low-value because: 1.        Radiation response is slow and non-linear, 2.        Residual cells often represent senescence, not recurrence. 3.        Histology cannot reliably distinguish between the two. 4.        Management based on routine biopsy findings can harm patients

GU malignancies drug approvals in 2025 ⬇️

🚨 NEW ASTRO GUIDELINE DROP! ☢️Radiation Therapy in Gastric Cancer - What Actually Changes? 1. Resectable Disease: Where RT Fits 🔹 Perioperative chemotherapy (FLOT) = Standard •FLOT4 ➝ FLOT > ECF/ECX •MATTERHORN ➝ FLOT + durvalumab ↑ pCR & ↑ EFS •KEYNOTE-585 ➝ ↑ pCR but no OS benefit with pembrolizumab •Asian data: CLASSIC, ACTS-GC, ARTIST 2 for postop chemo 🔹 Preoperative chemoRT Use only if: ❌ Not fit for peri-op chemo ❗ Borderline resectable (high R1/R2 risk) 🔼 Restrict to GEJ / upper & mid-stomach Key evidence: •TOPGEAR ➝ ↑ downstaging, ↑ pCR (17% vs 8%) •POET, KROSG 0301, UYG-GO (supportive phase II data) Regimen: 45 Gy/25F + 5-FU/capecitabine 🔹 Postoperative chemoRT Use when: •#OncoTwitter #GIcancer #RadOnc #MedTwitter @OncoAlert @myesmo @esmo_open @ASCO @ASTRO_org

📊 10-year STARS trial results: SABR is noninferior to VATS surgery for pts with operable early-stage NSCLC #LCSM ✔ Similar long-term OS ✔ Far fewer short-term complications (1% vs 50%) ✔ Strong noninvasive option for select patients 👨‍⚕️ @JoeChangMD 🔗 ascopost.com/issues/novembe…

Localised prostate cancer just changed. Again. ESMO 2026 brings clarity on who to observe, who to escalate, and which trials actually matter 👇 🧠 Diagnosis MRI before biopsy is standard High-resolution US is a valid alternative (RCT n=678) 🧭 Low risk Active surveillance is safe ProtecT 15-yr data shows similar survival vs RP/RT ☢️ Radiotherapy Shorter is better CHHiP ➜ moderate hypofractionation HYPO-RT-PC ➜ ultra-hypofractionation PACE-B ➜ SBRT works in selected IR disease 📈 High risk RT + long-term ADT saves lives SPCG-7 | NCIC/MRC Dose escalation improves OS (GETUG-AFU 18) 🚨 Very high-risk / cN1 RT + ADT + abiraterone is the new benchmark STAMPEDE delivers MFS + OS benefit 🔁 Biochemical recurrence Avoid routine adjuvant RT Early salvage RT preferred RADICALS-RT | RAVES | GETUG-AFU 17 High-risk BCR? Intensify EMBARK supports enzalutamide + ADT 🧠 Bottom line Risk-adapted care > overtreatment Imaging-driven decisions Escalate only when trials prove benefit 📖 Full paper in comment ⬇️ #OncoTwitter #MedTwitter #ProstateCancer #GUOncology @OncoAlert @myesmo @esmo_open @asco @OncBrothers

@sebas_arruarana @UofC Rubab.batool2@nhs.net

FREE Clinical Research & Ethics Training 🚀 | By the University of Chicago @UofC Looking to strengthen your research foundation? The Essentials of Patient-Oriented Research (EPOR) at the University of Chicago is a high-yield program designed to teach you how real clinical research is done—from study design to ethics and data integrity! The Winter EPOR: Ethics of Clinical Research (RCR) meets NIH/NSF Responsible Conduct of Research requirements, covering conflicts of interest, human and animal research ethics, intellectual property, and real-world challenges scientists face. It’s free, virtual (Zoom), and open to students, residents, fellows, nurses, and faculty! 📅 Jan 6 – Mar 10 | Tuesdays 5:15–6:15 PM 📜 Certificate awarded (8/10 sessions required) ⏰ Deadline to sign up: Jan 19 💬 Write your EMAIL👇 and I’ll email you the registration link.

Learning, reflection, and connection at the ESMO Preceptorship Course. Grateful for the opportunity to attend such insightful and thought-provoking sessions. Thank you to @Ecastromarcos and the @myESMO faculty for excellent talks.

Learning, reflection, and connection at the ESMO Preceptorship Course. Grateful for the opportunity to deepen my knowledge. #esmoperceptorship

👉 Please make sure you’re receiving these emails from the College — they’re packed with essential resources to support your training and career #RCR

1-Excited to share the latest Resident Doctor Newsletter from @RCRadiologists David and I have been working closely with Dean Simmons and the RCR team to bring timely updates, exam support, wellbeing insights, and specialty news straight to your inbox comms.rcr.ac.uk/cr/AQjt4RUQgPH…

Rewatching #BreakingBad in 2025 with fresh eyes as #Radonc resident☢️ Let's talk about how Walter White's Stage IIIA lung adenocarcinoma would be treated if diagnosed today instead of 2008. 🧵 #lcsm #MedTwitter Because honestly? The show may look very different. Here's why...

@RaziaAliani Would love to check it out!

I've met tons of researchers who hate stats! If you're one of these, this book is for you ⤵️ Save (with 𝘤𝘭𝘪𝘱𝘱𝘦.𝘮𝘦) & Repost The author says it perfectly: "The most important concepts of statistics can be explained, so that ordinary people can understand it." — No complex formulas. — No expensive software needed. — Just spreadsheets & clear thinking. The book covers: — Sample surveys — Data presentation — Confidence intervals — Statistical tests Written for people who need to collect data. — Analyze results. — Present findings. But don't want to become mathematicians. Real examples throughout. — Like the Fitness Club survey with 30 kids. Shows you exactly how to spot bias. When to use different tests. How to avoid common mistakes. Perfect for public health researchers. Statistics doesn't have to be scary. (𝘢𝘵𝘭𝘦𝘢𝘴𝘵 𝘪𝘯 𝘵𝘩𝘦 𝘣𝘦𝘨𝘪𝘯𝘯𝘪𝘯𝘨) 💬 Comment if you'd like a link to download this book!

🚀 Calling ST3+ clinical oncology trainees! Apply to be Vice-Chair (Chair-Elect) at NOTCH — two-year leadership role starting Jan: Vice-Chair → Chair. Ideal for current committee members. Send expressions of interest to uk.notch@nhs.net by 12 Nov. #Oncology

@ClinOncDoc Thanks so much, Gaggan! You were the one who first showed me the beauty of radiotherapy — grateful always.

@Rubab_Aftab Congrats! It wasn’t that long ago you were asking for advice on applying to the specialty!!

1-Years of hard work, sacrifice, and so much support from family, friends, and mentors — and here comes the day: #RCRFellows Ceremony. Grateful to God, to all the people who helped me along this journey, to all the experiences that shaped me, the hardships that made me resilient