Smitha Krishnamurthi

Excellent Leadership opportunity at @ClevelandClinic Program Director for Thoracic Medical Oncology careercenter.asco.org/job/7627827/th… @ASCO

@BiachiTiago @CathyEngMD @MoffittNews Congratulations Tiago!

Honored to step into the role of Section Head for Colorectal Cancer at @MoffittNews Warm congratulations to my colleagues who have been appointed Section Heads for their respective disease sites — truly a strong team moment. Looking forward to driving meaningful progress together for our patients. #MoffittCancerCenter #colorectalcancer

@GIMedOnc @sudhirkirar1 Great summary!

Daraxonrasib in PDAC now published in NEJM. We have had press releases and presentations, but now a publication. And yes, the data still look very real. 🧬 Pancreatic cancer is a RAS disease. 90% have activating RAS mutations. G12D, G12V, G12R dominate. And historically we have had essentially nothing direct to do about it (G12C inhibitors exist but they are a subpopulation). Phase 1/2 Previously treated RAS-mutant PDAC n=168 Oral RAS(ON) multi-selective inhibitor Phase 3 dose: 300 mg daily • ORR 35% • mDoR 8.2 months • mPFS 8.5 months • mOS 13.1 months As context; 2L chemo w/ PDAC has ORR <10% with OS ~5-7 months and significant side effects. So yes, this is huge. Toxicity is real too: • Any-grade TRAE 96% • Grade ≥3 TRAE 30% • Rash, diarrhea, nausea, mucositis, vomiting, fatigue This is not a “write the script and see them in a month” drug. Up-front oncoderm involvement is going to be critical. Rash needs to be anticipated, managed early, and dose modifications need to be normalized rather than viewed as failure. BUT this is a absolute game-changer in pancreas cancer (and other KRAS driven diseases). Importantly, this no longer exists in a phase 1/2 vacuum. By press release, RASolute 302 met its primary and key secondary endpoints, with PFS and OS benefit versus standard chemotherapy. Full data still matter, but the confirmatory study appears to have confirmed the signal. Terrible disease. Great signal. Real (but manageable) toxicity. Practice-changing. nejm.org/doi/full/10.10… @OncoAlert @TheGutOncLab @Onco_Nexus

👀This novel study using methylation scores to identify exposures in patients with #Colorectal #Cancer finds an association with the herbicide picloram and #EOCRC- a potential new risk factor worthy of study! Picloram was introduced in the US in 1963. Congrats to authors @VHIO

@CathyEngMD @AACR @ClevelandClinic @SWOG Was the highlight of my meeting- catching up with @CathyEngMD and @VanMorrisMD !

Plus also catching up at lunch with my @AACR Vail workshop fellow graduate @smitha42 @ClevelandClinic ! @SWOG

@DennisJHsu Wow! What’s next Dennis?

Today wraps up my time on faculty at UPMC. I’m incredibly grateful to my team, co-faculty, research collaborators, and the people of Pittsburgh and western PA who have trusted me with their care. Wherever I go, I’ll have a cool signed Pirates hat!

Congratulations @MyriamChalabi ! So happy to see your bold, inspiring work recognized! 👏🏽👏🏽👏🏽Love the video too! 😊 Innovators in Science Award: 2026 Grand Prize Winner Myriam Chalabi youtu.be/ch_Zhvf4GJY?si… via @YouTube

@FunchainMD @crisbergerot @ASCO @HwakeleeMD @jamecancerdoc @montypal @BrainTumorDoc @PGrivasMDPhD @VamsiVelcheti Congrats Pauline!

Amazing honor @ASCO - thank you 🙏 Have to thank @HwakeleeMD and @jamecancerdoc for their support to grow in their cancer centers to get to this point, and @montypal @BrainTumorDoc @PGrivasMDPhD @VamsiVelcheti for being inspirations along the way 🏔️

Out of press! Amivantamab (fully human, bispecific IgG1 monoclonal antibody) that targets EGFR and MET Monotherapy in Chemorefractory RAS/BRAF Wild-Type Metastatic Colorectal Cancer: Results From OrigAMI-1, an Open-Label, Phase Ib/II Study | Journal of Clinical Oncology ascopubs.org/doi/10.1200/JC… @ASCO #colorectalcancer #cancer Enroll to #Origami2 (NCT06662786) and #Origami3 (NCT06750094) Vanderbilt University Medical Center

Very sad to see this. I remember Asal speaking so passionately about the need for clinical trials with the goal of extending the benefit of immunotherapy to all patients with colorectal cancer. @CathyEngMD @ctycka @FightCRC

@Aiims1742 @AACR @Carolynyjohnson @Perlmutter_CC @nyulangone Thanks for all your posts, Anirban! Made me feel like I was there. Will be catching up virtually this weekend.

Back home from #AACR26 on the red eye from San Diego. This meeting really felt like we were turning the tide on #PancreaticCancer. If you missed the session, you can watch it (and all others) on the @AACR virtual platform. Thanks @Carolynyjohnson washingtonpost.com/health/2026/04…

Short term data but incredible

Phase 1/2 data re: @AACR #AACR2026 Daraxonrasib + Gem/nab-paclitaxel (N=40) by Dr. Wolpin: ORR = 58% and 6M OS = 90%. RASolute 302 to be presented at @ASCO #ASCO2026. RASolute 303 is now open for 1st line. #pancreaticcancer @PanCAN @Rev_Medicine #cancer #cancerresearch @OncoAlert

Metastatic pancreatic cancer in the @ASCO plenary! Finally! Our patients are waiting

@marklewismd So well deserved! Congratulations!

Since many of you have supported my daughter’s paintings when I’ve shared them on here, I’m delighted to report that she just won a statewide award among Utah high school students for her excellence in the visual arts I am one proud papa! deseret.com/utah/2026/04/1…

@Banana_Oncology The Biology of Cancer- one of the best books ever!

Heard Bob is (finally) retiring soon. What a celebrating career and thanks for all he did for the entire oncology field His training record is also completely off the chart. Look at the lineage from his lab, absolutely amazing!

@GIMedOnc @sudhirkirar1 Love the high DFS with short duration neoadjuvant ipi/nivo. Regarding long term follow up, there’s also small PICC trial of neoadjuvant toripalimab +/- celecoxib: 5 year EFS 100% and 93%. thelancet.com/journals/eclin…

IMHOTEP just gave us something we’ve been looking for in MSI-H colon cancer: prospective single-agent PD-1 data in the localized setting. And honestly… this is great. 🧬 Because the field now looks like this: • NICHE-1 / NICHE-2 → dual IO, pCR ~60–67% in colon (and no recurrences) • Dostarlimab nonoperative rectal cancer study → single-agent PD-1, opening the NOM conversation Now IMHOTEP (pembro alone 1-2 cycles neoadjuvant and 1 year afterward): • pCR: 53% overall • 1 cycle: 46% • 2 cycles: 68% • Median follow-up ~24 months • Only 3 recurrences 👀 ~70% pCR with just two doses of pembrolizumab is impressive. But what stands out is the follow-up. At ~2 years, 3 recurrences. Now compare: NICHE-2 (nivo + ipi 2 cycles neoadjuvant) • pCR ~67% • Near-universal response rates • No recurrences IMHOTEP (pembro 2 cycles neoadjuvant + 1 year after) • pCR ~68% (with 2 cycles) • Low early recurrence signal Questions I'm pondering: Is that additional year of single agent worth it? Should we be offering nonoperative management or using a neoadjuvant playbook (100% DFS is incredibly). 🤔 Wondering what other people are doing for these patients today... ascopubs.org/doi/10.1200/JC… @OncoAlert @Onco_Nexus @TheGutOncLab @OncBrothers

🚨🚨🚨 RASOLUTE-302 Ph3 is POSITIVE "Daraxonrasib demonstrated a median OS of 13.2 months versus 6.7 months for chemotherapy, with a hazard ratio of 0.40 (p < 0.0001)".... WOW! AMAZING news for patients with #PancreaticCancer The RAS Revolution is ON!! ir.revmed.com/news-releases/…

With the new BREAKWATER FOLFIRI data, when it’s time to drop oxaliplatin due to neuropathy, I will add in irinotecan. The last patient I treated before this data came out had a wonderful response to FOLFOX/encorafenib/cetux but then the CEA started climbing soon after oxaliplatin was stopped. Wish exceptional responses were the norm!

Just made a decision I never expected to make in BRAF V600E mCRC: Stopping treatment. Peritoneal metastases. BREAKWATER regimen. ctDNA negative >1 year. Direct peritoneal visualization — clear. Two years on treatment. After initial response, I dropped oxaliplatin and maintained on 5-FU + encorafenib + cetuximab for ~18 months with excellent tolerability and sustained response. Two questions for #GIOnc Twitter: 1️⃣ Should maintenance de-escalation (drop oxali, continue 5-FU/enco/cetux) be standard after response in BRAF+ mCRC? 2️⃣ For exceptional responders with sustained ctDNA negativity and no detectable disease — is it safe to study treatment holidays? n=1 ≠ evidence. But exceptional responders reveal biology. And biology should drive the next trial designs. @OncoAlert @TheGutOncLab

Congratulations @rachnatshroff ! So well deserved!