Maged Khalil, MD

Today on National Clinical Trials Day, we honor the patients and research teams who turn hope into progress. Every breakthrough in medicine begins with courage, compassion, and science working together. Grateful to all who make this mission possible. #ClinicalTrials #Oncology

@CathyEngMD @VautheyMD @UTMDAnderson @VUMCDiscoveries @VUMChealth @jordanberlin5 Would this accessible or available online ?

Delighted to have @VautheyMD @UTMDAnderson internationally recognized expert in #surgical #oncology #cancerresearch will be giving @VUMCDiscoveries @VUMChealth Grand Rounds today. #cancer @jordanberlin5

Channing J. Der, PhD, and Jen Jen Yeh, MD, describe the scientific foundations of a phase 1–2 study of daraxonrasib to treat metastatic pancreatic ductal adenocarcinomas. Learn about the science behind the study in the editorial “Advances in RAS Therapeutics for Pancreatic Cancer,” from the University of North Carolina at Chapel Hill (@unc): nej.md/4neOTCE

Disruptive Analysis of Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer: Clinical and Therapeutic Distinctions Between Lowand Mid-Rectal Cancers @JCO_ASCO doi.org/10.1200/JCO-25… 👏excellent review 👉Adopting a location-specific, patient-centered approach is key @myESMO @ASCO

Neoadjuvant CTLA-4/PD-(L)1 Blockade Versus Surgery +/− Chemotherapy in Deficient Mismatch Repair/Microsatellite Instability–High Resectable Gastroesophageal Adenocarcinoma: Individual Patient Data Pooled Analysis buff.ly/6JPU5g9 This pooled analysis of 197 patients with resectable deficient mismatch repair (dMMR)/microsatellite instability-high (MSI-H) gastroesophageal adenocarcinoma (GEA) evaluated outcomes across different treatment strategies, including neoadjuvant immune checkpoint inhibitors (ICIs), perioperative FLOT chemotherapy, and surgery with or without older chemotherapy regimens. Patients receiving ICIs achieved markedly higher pathologic complete and major response rates (pCR 61.9% vs 3.7%; MPR 78.6% vs 10% with FLOT) and demonstrated greater tumor and nodal downstaging. Despite these improvements, event-free and overall survival were similar between groups. Residual nodal disease or advanced local stage (ypT4) after preoperative therapy predicted poorer outcomes. Overall, neoadjuvant ICIs offer superior pathologic responses compared with chemotherapy, supporting their use as the preferred preoperative approach and providing a rationale to explore organ-sparing or nonoperative strategies in this molecularly defined GEA population. @ABallhausenMD @sara_lonardi1 @david_tougeron @giammi107 @JeeyunM @MichelePriscia3 @ChiaraPircher @paomanca @margheambro1 @FraBerghy @PiessenG @LizzySmyth1 @ModestDominik @alba_mici @FilippoPietran4 #OncoAlertAF @nataliagandur @acampsmalea @BRicciutiMD @yekeduz_emre @HHorinouchi @FadiHaddad_MD @Abdallah81MD @FernandoOnco @ElisaAgostinett @to_be_elizabeth @bavilima @realbowtiedoc @Erman_Akkus @Lucarecco @GaiaGriguolo @JankovicK @MarioBalsaMD @DrMirallas @GIMedOnc @OscarTahuahua @UOzkerim @DrRishabhOnco @Onco_Cifu88

@DrKatePedersen So grateful to have such a great option for very aggressive cancer

BREAKWATER shows that 1L EC+FOLFOX results in mPFS 12.8m and mOS 30.3m!! 🥹🥲 That mOS far exceeded my greatest hope for this study. A great turning point for a bad actor 🙌👊🏻 #ASCO25

Volvo Financial ruined our credit on the first payment. We set up direct withdrawal, they failed to process it, never notified us, and then reported it late. No accountability. Serious damage to our family. Never again. #VolvoFinancial #CreditDamage

While phase 3 oncology trials frequently report success based on alternative endpoints, actual enhancements in overall survival and quality of life are uncommon. ja.ma/4m3Eesv @AlexSherryMD @oncology_bg @PavlosMsaouel @ebludmir

🔬 ATOMIC trial follow-up data for dMMR stage III colon cancer🥼 📢 ASCO 2025 Update from Chicago 🏙️ ✅ Atezolizumab + mFOLFOX6 shows sustained 3-yr DFS of 86.4% vs 76.6% with mFOLFOX6 alone (HR: 0.50, p<0.0001). 📰ARTICLE: oncologytube.com/atomic-trial-a… 📺YOUTUBE: youtu.be/WpToVAAS6sw 🛡️ Safety profile remains consistent with prior reports. 💡 Implications for adjuvant therapy in MSI-H colorectal cancer discussed at #ASCO25 @OncoAlert @ASCO #cancer #oncology #MedX #colon @Erman_Akkus @MollyDu127 @UmutDisel @jrgralow @onco_pedia @aldolealp @isdanieljeong @pierrerod @CharlesDariane @DraMartinezLago @GI_Onc_PubMed @Stefani19753108 @EmilyHarrold6 @MedicalwatchFTW @ptsdhillon @YnfaYr @umajeed_90 @PiotrWysockiMD @SuyogCancer @ronanhsieh @cancerkc @drdeniztural @dralsharm @GlopesMd @KaiKeenShiu @SouraskyMedCtr @NorthwesternU @prof_gina_brown @FoxChaseCancer @agrothey @caseccc @skopetz @MDAndersonNews @EdithMitchellMD @ColonCancerFdn @RachelRiechelm2 @pashtoonkasi @mtmdphd @SKamath_MD @drkeithsiau

I have been naming this for years as the top patient intervention to reduce the risk of colorectal cancer recurrence. Ever since this study was published: pubmed.ncbi.nlm.nih.gov/16822844/

#ASCO25 Neoadjuvant or adjuvant in dMMR colon cancer? Looks like we’ll be discussing this at length today. Let’s start with this comparison👇

The NCCN has included adjuvant atezolizumab (for 1 year) in the treatment of stage pT2c–III dMMR colon cancer. Given the positive trial results, its inclusion is certainly appropriate. However, the guideline adopts a somewhat conservative stance regarding neoadjuvant ICI use, limiting it only to cases with cT4b tumors or bulky positive lymph nodes. In the NICHE-2 study, however, 57% of patients were staged as cT3–cT4a. Achieving a 3-year DFS of 100% with just 4 weeks of neoadjuvant ICI suggests that restricting this approach to such a narrow population may not be entirely reasonable. We recognize the limitations of clinical staging, but these can be improved. In my view, neoadjuvant strategies that demonstrate a “less is more” effect deserve broader clinical adoption. Trials like NADINA, NICHE-2, and perhaps CheckMate-816( !?) point in this direction.

Worthy of a plenary session — CO.21 shows that exercise reduces recurrence after adjuvant and improves OS

If I can achieve the following result with neoadj 2 doses of nivo + 1 dose of ipi, I see no compelling reason to prefer 6 months of chemotherapy plus 1 year of ICI in the adjuvant setting. NICHE-2👇

Great discussion by @MyriamChalabi on ATOMIC I still feel and like many of others, 2 cycles of neoadjuvant IO are enough, for all pts with stage 3 dMMR ca colon pts . We have learned this from melanoma , that neo adjuvant IO is way better than Adjuvant IO Sorry, ATOMIC has no blast @ASCO @OncoAlert @GIcancerDoc @GIMedOnc @UGrewalMD @NiuSanford

#ASCO25 #Plenary @ASCO LBA1 - ATOMIC - mFOLFOX6 +\- atezoX1y in stage 3 dMMR colon cancer @ALLIANCE_org n=712, 54% high-risk ➡️3yDFS 86.4% vs 76.7%, HR 0.50p<0.001 ➡️OS immature -2 deaths in combo arm 👏 @FASinicropeMD Questions remain: 📌do we need FOLFOX? 📌 do we need 1 year of PD1? 📌 is neoadjuvant approach better? …looking forward to discussant @MyriamChalabi @OncoAlert

Day 3 #ASCO2025 Before LBA1 + LBA5 break cover, it’s already been a 🙌 2 days for #GIonc !🧐 BREAKWATER: nejm.org/doi/full/10.10… DESTINY-Gastric04 nejm.org/doi/full/10.10… PANOVA-3 ascopubs.org/doi/10.1200/JC… LEAP-015: ascopubs.org/doi/10.1200/JC… ClaudinCarT : thelancet.com/journals/lance…

Matterhorn falters on OS EFS HR 0.71 🧪 NEJM MATTERHORN Trial — Periop Durvalumab + FLOT in Resectable Gastric/GEJ Cancer n=948 | Global Phase 3 | FLOT backbone 🎯 Primary Endpoint: Event-Free Survival (EFS) 📊 2-yr EFS: 67.4% vs 58.5% 🕒 Median EFS: NR vs 32.8 mo 🧮 HR 0.71 (95% CI: 0.58–0.86), p < 0.001 🧬 Pathologic CR: 🔹 19.2% vs 7.2% 🔹 RR 2.69 (95% CI: 1.86–3.90) ⚰️ Overall Survival (OS) 📆 24-mo OS: 75.7% vs 70.4% 🕒 Median OS: NR vs 32.8 mo 🧮 HR (0–12m): 0.99 → ❌ no early OS benefit 🧮 HR (≥12m): 0.67 → ✅ delayed IO effect 📉 OS p = 0.03 > alpha (0.0001) → Not significant yet 🛡 Safety 🧾 G3–4 AEs: ~71% both arms 💥 irAEs: 23.2% (vs 7.2%) 🕒 Delayed surgery: ~10% both arms ⚖️ Critique ❗ EFS + pCR ✔️ ❗ OS ✖️ not yet significant ⚠️ No clear biomarker enrichment (PD-L1 or MSI-H) 🛠 Surgical variability not controlled 🧪 Awaiting final OS for SoC impact 🧠 Verdict: Encouraging but not SoC (yet). #NEJM #ASCO25 #GastricCancer #Immunotherapy #Durvalumab #OncoTwitter @dr_yakupergun @GIMedOnc @GIcancerDoc @UGrewalMD @OncoAlert