Shaalan Beg MD MBA FASCO

On the latest episode of @TheGutOncLab, @NiuSanford joined @GIMedOnc & @TimothyJBrownMD to discuss the dynamics of long-term surveillance after organ preservation in upper GI cancers. They break down how rigorous follow-up, tight multidisciplinary coordination, and smart patient selection make this strategy both safe and sustainable over time. Watch the full episode below: oncologynexus.com/podcast/gut-on… Live on Spotify/Apple Tomorrow!

Perioperative durvalumab (12 months) with neoadjuvant EV (3 cycles) shows ‘statistically significant and clinically meaningful’ improved EFS and OS vs cystectomy alone in MIBC (like KN905 (EVP cs cystectomy)). The shorter period of EV is the major difference in trial designs. Details of efficacy and toxicity will be important. The 3rd arm, where tremelimumab was added as a triplet, did not hit OS at this stage. astrazeneca.com/media-centre/p… @OncoAlert

1/14 Why can't you use direct oral anticoagulants (DOACs) in patients with mechanical valves (MVs)? DOACs have been one of the most important advances in my career. And yet, the presence of a MV is one of the few contraindications. The reason highlights the unique nature of thrombus formation in those with a MV and provides insights into the evolution of human hemostasis.

Yes, we got 2 approvals today but also important to keep an eye out for these withdrawals. @US_FDA withdrawal of tazemetostat tablets earlier this week due to an increased rate of hematologic second primary malignancies. Approved in 2020 to treat metastatic or locally advanced epithelioid sarcoma and for R/R follicular lymphoma. @OncoAlert @OncUpdates @BijoyTelivala @RenoHemonc @Papa_Heme

This is an absolutely outstanding review on the management of patients with metastatic gastric cancer. I may have posted about this review before but it is so good that it deserves another round of applause... Thanks @KlempnerSam @YJanjigianMD @amalsargsyan and all the other co-authors I could not find on X... Sorry AI, I love you but you are just not there yet. True content experts writing a practical review still beat you easily. This should be a required read for all who take care of patients with gastric cancer. nature.com/articles/s4157…

If you are a senior oncologist and have been first author on a billion clinical trials now might be the time to let a younger academic doc take the lead.

If insurance companies can deny care and call it "medically unnecessary", why aren't they required to have malpractice insurance doe when they get it wrong and someone gets sicker or tragically dies ?

A few additional thoughts I've had reflecting upon lessons from daraxonrasib in addition to Wungki's excellent summary below

We'll need faster trials, regulatory understanding, and more investigators pushing multiple on- and off-mechanism ways to kill the same tumor. No one thinks of HIV therapy in terms of one target. Will have to be the same for cancer, but we're really not there.

New paper in @NatRevClinOncol ! We propose “time budgeting” as a new design principle for cancer care: treating patient time as a finite resource that should be measured, protected, and incorporated into care pathways & clinical trials. Because time is also a toxicity. ⏳

@Deebacca @christianacare @Sarbaji85064063 Congrats!

📣📣Announcing my new role @christianacare as Chief of GI Oncology and Director of Clinical Trials & Clinical Research for Solid Tumors. Grateful to my RPCI colleagues and mentors (esp @Sarbaji85064063) for their support. Looking forward to advancing cancer care in this new role

We don’t have a technology problem in clinical trials. We have an execution problem. Remote consent. Telemedicine visits. Multisite co-management — already FDA permissible, yet underused due to inertia. ajmc.com/view/the-scien…

Sharing our latest article with @MuhammetOzerMD out in @JCOOP_ASCO “Repurposing Renin-Angiotensin System Inhibitors in Colon Cancer: Signal, Plausibility, and the Need for Prospective Validation”, discussing drug repurposing in oncology @TheGutOncLab ascopubs.org/doi/10.1200/OP…

#ASCO26 is <4 weeks away! @ASCO Here are the #GI oncology oral abstracts I’m most excited about 👇 ➡️Notable phase 3s: PDAC: RASolute302 ⭐️ HCC: EMERALD-3 & IMBRAVE251 EGC: ATTRACTION 6 & BL-B01D1-305 CC: FIGHT-302 CRC: PUMP (HAI), EPISODE-III (ASA) - HER2+: Tras rezetecan (SHR-A1811) - BRAFm: Tunlametinib in pre-treated Congrats to all the presenters - special shoutout to our 🇨🇦 GI oral presenters & discussants 🤗 See you in Chicago! #GIOncology #CRC #PDAC #RAS #HCC

Dr. Ethan Ludmir @ebludmir is brilliant, humble & so quietly impressive. Loved getting to chat with him about many topics – oligometastatic pancreas ca, Bayesian statistics, career advice & more. Full video link below. Watch if you want to become inspired about GI onc/rad onc!

Targeting Ras in pancreatic cancer - the last 30 years

TWO DAYS after receiving the application, FDA greenlit the new pancreatic cancer drug daraxonrasib for expanded access. This drug has also been granted a national priority voucher, which means a full application could be reviewed in a matter of weeks instead of 10-12 months.

Vepdegestrant (PROTAC ER degrader) @US_FDA ✅ for HR+ metastatic breast based off #Veritac2 Ph III vs. (Fulvestrant) after CDK4/6i + AI: - mPFS 5.0 vs 2.1 mos in ESR1m (HR=0.57) - OS is immature - Well-tolerated, low discontinuation #bcsm @OncUpdates @OncoAlert

⭐️🚨It’s Friday & we have a new FDA approval 👉🏼FDA approves vepdegestrant for ER-positive, HER2-negative, ESR1-mutated advanced or metastatic breast cancer #precisionmedicine @OncoAlert @MedwatchKate @oncodaily fda.gov/drugs/resource…

We have the evidence We have the tools We have the guidelines But adoption is still low As @WilliamDale_MD noted: the next challenge isn’t discovery, it’s implementation @PallOncCoP @realbowtiedoc @JamesFanWu @FionnualaCrowle @Chaosdyna @jillfeldman4 @DarcyBurbage @ramsedhom