Jennifer Le Guévelou retweeted
Six phase III trials. Six different stories.
Higher pCR does not guarantee better survival.
In muscle-invasive bladder cancer, EFS and OS matter more than impressive response rates.
Are we measuring what truly matters to patients?
@myESMO @OncoAlert @OpenMedicineHQ #ESMO26 @tompowles1 @urologysummit @Uromigos @Uroweb @urotoday
Jennifer Le Guévelou retweeted
Adam Siao Him Fa 🇫🇷 Free Skate at Grand Prix de France 2026‼️FIRST
3 QUADS + 2 3A’s ADAM WINS GPF
🎶 Here Comes the River 🎶
FS: 181.78 TOTAL: 284.24 🏆
Jennifer Le Guévelou retweeted
Improved MFS w/ darolutamide in DASL-HiCaP!
📌 1,106 very high-risk prostate cancer pts, incl persistent/rising PSA after RP. Randomised to darolutamide vs placebo w/ ADT + RT.
📌 Median age 71; GS 9-10 73%; CT N+ 29%; prior RP 15%.
📌 4y MFS on conventional imaging: 95% vs 88%, HR 0.42 (95% CI 0.27-0.66). No clear OS benefit yet.
📌 All prescribed prostate/bed AND pelvic nodal RT, w/ 96 wk ADT.
📌 N+ = CT/MRI >10 mm short axis or path confirmation (PSMA PET alone insufficient if ≤10 mm).
Side note: RT dose/fx and PSMA staging use aren't reported in the abstract. #radonc #ESMO26 #PCSM
Jennifer Le Guévelou retweeted
#ESMO26 PROTEUS discussion by Nicholas van As
• No baseline PSMA PET; enrolled conventionally staged M0
• MFS events: true progression or delayed detection? Most were PSMA PET-detected (8.8% vs 16.3%)
• TTST HR 0.29, but ~20-mo lead-time bias
#ProstateCancer
Jennifer Le Guévelou retweeted
🚨📣📣 #ESMO26 presidential: @niazi_Dr7 Adding darolutamide to ADT + RT dramatically ⬇️ risk of metastasis or death in high-risk localized prostate cancer. Phase 3 DASL-HiCaP = 58% ⬇️ in MFS (HR 0.42) + early OS signal (HR 0.88). #ProstateCancer #RadOnc #pcsm @ChrisSweens1
Jennifer Le Guévelou retweeted
🚨📣 big news at #ESMO26: 🧵1/MASTERPLAN RCT shows adding SABR to perioperative chemotherapy for high-risk localized #pancreatic cancer ⬆️⬆️ median overall survival to 22.0 months vs 14.0 months (HR 0.45). #PancreaticCancer #RadOnc @TROGfightcancer in press @TheLancetOncol - thelancet.com/journals/lanon…
Jennifer Le Guévelou retweeted
Can we improve androgen deprivation therapy for treating prostate cancer?
In @EurUrolOncol, @ArashRezazadeh6 and I discuss the data for transdermal estradiol (tE2) patch.
Despite a phase III study being published several months ago, tE2 remains absent from treatment guidelines.
There are several advantages to tE2 including less hot flashes, less negative effect on bone health, and less financial toxicity.
Link (free text): authors.elsevier.com/a/1nkp9…
Jennifer Le Guévelou retweeted
🧬 Could PSMA PET/CT become more than a staging tool—and actually help us measure treatment response?
Article 📰
sciencedirect.com/science/ar…
PSMA PET/CT Kinetics During Systemic Therapy and Radiotherapy in Hormone-sensitive Prostate Cancer: A Systematic Review
A systematic review of 11 studies evaluated PSMA PET/CT for treatment response assessment in hormone-sensitive #ProstateCancer .
➡️ ADT generally reduced PSMA expression, although an early flare was observed in a subset of lesions, particularly bone metastases.
➡️ Following radiotherapy ☢️ , PSMA reductions appeared greater when ADT was added.
✅ These findings suggest PSMA PET parameters could potentially help personalize treatment monitoring, but their association with long-term oncological outcomes remains to be established.
@JennKa12, @MBauckneht, @ClaudiaKesch, @GGandaglia, @dr_rajwa, @Fabio_Zattoni, @AlbertoMartini_, @veerukasi, @Lara__Rodriguez, @fazekasMD, @TheGiesen, @m_martinamaggi, @CMercinelli, @miszczyk_marcin, @JGomezRivas, @ruimmbernardino, @alibourgi1_ali, @Tilki_De, @GMarra_MD, @EAU_YAUProstate
@OncoAlert 🚨 #LPCCC27
@Silke_Gillessen
@AOmlin
@ProfKHerrmann
@weoncologists
Jennifer Le Guévelou retweeted
PSMA PET/CT kinetics during systemic therapy and radiotherapy in hormone-sensitive prostate cancer.
🔬 We reviewed 11 studies exploring how PSMA expression changes during treatment. Key messages:
➡️ ADT generally reduces PSMA expression across prostate, nodal and bone lesions.
➡️ An early PSMA “flare”can occur, particularly in bone metastases, highlighting the importance of timing when interpreting PET/CT.
➡️ Changes in PSMA PET parameters may eventually provide an imaging biomarker of treatment response and help guide treatment escalation or de-escalation.
➡️ However, current evidence remains heterogeneous, and prospective validation linked to oncological outcomes is still needed.
#ProstateCancer #PSMA #NuclearMedicine #Urology
sciencedirect.com/science/ar…
Jennifer Le Guévelou retweeted
A patient with prostate cancer is about to start androgen deprivation therapy. Where do you find the cardiovascular guidance—and how do you turn that guidance into a practical risk assessment?
That’s the journey I demonstrate in this video.
I built the Cardio-Oncology Living Guideline to make evidence easier to find and use across cancer types and treatments, with a dedicated cardiovascular risk tool for prostate cancer.
Explore it here:
cardonc-guideline.com
In the walkthrough, I show how to:
• Find what has changed: review evidence published since the 2022 ESC cardio-oncology guidelines - academic.oup.com/eurheartj/a… and see proposed recommendation updates.
• Navigate to the clinical question: search for a treatment or topic, open the relevant section, and follow the references to the original evidence.
• Assess cardiovascular risk in prostate cancer: start with rapid triage, then add optional Guha–Stabellini scores and AHA PREVENT base-model estimates when the necessary information is available.
• Generate a report: bring the assessment together for clinician review and support clinical documentation.
The rapid triage pathway can be used without entering laboratory values. Numeric assessment sits in a separate tab, so clinicians can choose the level of detail appropriate to the encounter.
AI (OpenAI ASTRA models) helps gather and organize evidence. I personally review every proposed update against the original sources before publication. Human review and editorial accountability are central to this project.
This is an independent educational resource. The website clearly distinguishes proposed recommendation changes from formally adopted ESC guidance.
For our cardio-oncology community, including colleagues in the @ICOSociety, I hope this helps connect evidence reading with structuring an assessment in clinic.
Watch the demonstration, explore the guideline, and try the calculator.
What would make this more useful in your practice? Feedback on navigation, clinical content, and the calculator will help shape the next updates.
#CardioOncology #MedicalEducation
@mcg_urology @md_addison @CardioOncology @OncoAlert @OncBrothers @datsunian @DrGuptaD @daehyunleemd @DrBonnieKy @DrTochiOkwuosa @drbrowncares @MCG_AUG @ACCinTouch @escardio @MCGCardFellows @ASCOPost @neerajaiims @DrChoueiri @PCFnews @montypal @PGrivasMDPhD
Jennifer Le Guévelou retweeted
What's optimal adjuvant chemo for high-risk CA penis?
Our BACuP RCT (1st syst trial RCT in CA penis), published @JNCI_Now, found pacli-plat was better tolerated, with less severe AEs and hosp admissions than 5-FU-plat. academic.oup.com/jnci/advanc… @OncoAlert
#PenileCancer #GUOnc
Jennifer Le Guévelou retweeted
Jennifer Le Guévelou retweeted
🚨 Article Spotlight | #CurrentUrology
Could updated anatomical illustrations improve continence-sparing radical prostatectomy?
This Correspondence proposes refinements to the classic midline sagittal schematic of the prostate, bladder neck, urethra, and sphincteric complex.
🧩 Key updates:
• Clear depiction of the submucosal longitudinal smooth muscle layer
• More detailed three-layer detrusor architecture at the bladder neck
• Anatomical continuity of the detrusor apron and vesicoprostatic muscle
• A clearer surgical anatomy basis for continence-sparing techniques
🔗 doi.org/10.1097/CU9.00000000…
#Urology #UroSoMe #MedTwitter #ProstateCancer #RadicalProstatectomy #SurgicalAnatomy #Prostatectomy
Jennifer Le Guévelou retweeted
🚨 8 mutational processes explain 85% of primary #prostatecancer genomes 🚨
@Nature, Pan Prostate Cancer Group:
👥 959 primary tumours w/ WGS, median f/u 7 yrs
📊 SBS + indel + copy number + 6 new complex SV signatures combined into 8 integrated footprints
✅ 4 of them, in 37% of tumours, predicted metastasis independent of age, Gleason, stage, TMB (HRs 4.05 to 7.71)
✅ The same signatures analyzed one at a time predicted nothing, need to know the dominant cluster!
✅ In mCRPC, a replication-stress footprint predicted ARPI over taxane: HR 0.21 for treatment failure
⚠️ Retrospective, ARPI signal rests on 25 pts, WGS of course not routine practice
🎯 Bottom line: we keep asking is it HRD, is it BRCA. Under 3% of primary PCa answer yes. Integrate four kinds of variation instead and you stratify 85% of genomes.
🔗 doi.org/10.1038/s41586-026-1…
@AmerUrological @UroOnc @PCFnews @PCF_Science @SUO_YUO @UroOnc
Jennifer Le Guévelou retweeted
In a 10-yr follow-up of a randomized trial, Retzius-sparing RARP (better early continence) showed worse long-term cancer control than the anterior approach — 2.64x higher progression risk after adjustment. Post-hoc, hypothesis-generating. free link:authors.elsevier.com/a/1njm6…
Jennifer Le Guévelou retweeted
⚡️ Systematic review on ctDNA in urothelial bladder cancer: plasma and urine liquid biopsy as diagnostic, prognostic, and predictive tools across all disease stages.
ctDNA shows consistent prognostic value. Standardization of thresholds and platforms remains the key barrier to routine clinical use.
euoncology.europeanurology.c…
#BladderCancer @EurUrolOncol
Jennifer Le Guévelou retweeted
Testosterone therapy in men on active surveillance for prostate cancer is not associated with increased risk of disease progression auajournals.org/doi/10.1097/…
Jennifer Le Guévelou retweeted
RADICAL PC-2 gives the strongest randomized evidence yet for organizing #CardioOncology around #ProstateCancer: assess CV risk in everyone—but don’t refer every man starting ADT to a specialist. New at #ESC2026. 🧵 @JAMAInternalMed @JACCJournals @escardio #ESCCongress @DarrylLeong @pinthusj
Jennifer Le Guévelou retweeted
⚡️ INDIBLADE: ipi + nivo induction followed by chemoradiotherapy in stage II/III MIBC (n=50).
2-year bladder-intact EFS: 78%. 2-year OS: 96%.
ctDNA clearance after induction: strong predictor of BI-EFS (HR 8.3).
nature.com/articles/s41591-0…
#BladderCancer @NatureMedicine
Jennifer Le Guévelou retweeted
Cystectomy Can Be Spared in Selected Patients with Muscle-invasive Bladder Cancer and Complete Response Following Neoadjuvant Therapy - @EUplatinum @OncoAlert @urotoday #cCR @IBCG_BladderCA #Milancriteria @SanRaffaeleMI @MyUniSR europeanurology.com/article/…



















































