Ricardo Carvalho 🇧🇷 retweeted
ESMO 2026 - pancreatic cancer, all you need to know.
1) KRAS is finally druggable, which slammed the door open for a new era in treating this disease. This week, two drugs added to chemotherapy shrank tumors in 63–87% of patients, not just stabilization, numbers nobody has seen in this disease.
teapawt.org/yannickbuccella/status…
2) And one moved to where cure lives. Given before surgery, 97% of patients reached the operating table and every operation removed the tumor completely. Add immunotherapy to the mix and we might increase efficacy further.
teapawt.org/yannickbuccella/status…
Caveats throughout: early-phase, small, survival data immature, much of it from single countries. But this means progress never seen in treating this disease.
3) Daraxonrasib was the very first drug to revolutionize pancreatic cancer care and we continue to learn. Very early data seem to indicate a better efficacy of daraxonrasib with KRAS-G12V mutations rather than the more common G12D. Which in turn makes combinations with a dedicated G12D inhibitor like zoldonrasib very promising. Data pending, we should know more next year.
teapawt.org/yannickbuccella/status…
KRAS inhibitors strike once again: A pancreatic cancer combination just reported a 75% response rate in the untreated metastatic setting.
In a disease where 25-30% has been the ceiling for decades or forever.
This trial added a KRAS-G12D inhibitor - which is the most common KRAS variant - to standard chemotherapy in 50 patients: tumors shrank in 62.5% with a 2 chemo-drug-regimen, 75% with a 3-chemo-drug-regimen. In that second group, every patient's disease was at least held in check.
Still after all that daraxonrasib hype, those are mindblowing numbers. Absolutely unprecedented.
A bigger study in the same setting is currently running, I have already included patients there myself. Let’s see the final results of that, but they will be similar in my opinion.
Exciting times in pancreatic cancer care!
Ricardo Carvalho 🇧🇷 retweeted
SANO trial #ESMO26
Why were distant mets more frequent with active surveillance (46% vs 29%) despite no significant OS difference?
▪️More intensive surveillance may have increased detection
▪️Locoregional regrowth during active surveillance may contribute to distant mets
▪️Higher non-cancer mortality after surgery may partly explain the lack of a significant OS difference
👉Perioperative chemotherapy, including D-FLOT, is now preferred for many patients with adenocarcinoma (~75% of SANO). In the SCC subset (~25%), DFS KM curves appear similar, but adjusted HR was 2.12 (95% CI, 0.68-6.61).
Careful discussion and shared decision-making are essential when considering NOM after nCRT for esophageal cancer.
🔗doi.org/10.1016/j.annonc.202…
@Annals_Oncology @myESMO @OncoAlert
Ricardo Carvalho 🇧🇷 retweeted
Final OS in CheckMate 8HW #ESMO26
▪️NIVO + IPI significantly improved OS vs NIVO across all lines
▪️In 1L, a clinically relevant trend toward improved OS was observed, although not statistically significant
🔗doi.org/10.1016/j.annonc.202…
@myESMO @Annals_Oncology @OncoAlert
Ricardo Carvalho 🇧🇷 retweeted
Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest malignancies.
In @LancetGastroHep, a Review evaluates the clinical development of therapeutic cancer vaccines in PDAC: spkl.io/60107kQ3K
ALT Antigen sources and vaccine platforms in PDAC. Created in BioRender. Chap, B. S. (2026) https://BioRender.com/7xdlrqt. (A) Patient-derived tumour tissue can provide multiple antigen sources, including whole-tumour lysate, TAAs, TSAs, and neoantigens. These antigens undergo selection and, when applicable, computation epitope prediction to prioritise immunogenic targets, which are subsequently incorporated into a final vaccine formulation. (B) Several vaccine platforms are being explored in PDAC, including cell-based and dendritic cell-based vaccines, mRNA-based and DNA-based vaccines, peptide and protein vaccines, and microorganism-based approaches, all aiming to induce tumour-specific T-cell responses against the pancreatic tumour.
Ricardo Carvalho 🇧🇷 retweeted
📢 Gastric/GEJ highlights from ESMO 2026
GI oncologists Drs @LizzySmyth1 & @YJanjigianMD joined us in Madrid to share their first thoughts on new data presented at the @myESMO meeting
Will phase 3 data from CLARITY-Gastric 01 (CG-01) & G-HOPE-001 change clinical practice?
Watch to find out! 📺
See more from ESMO:
cor2ed.com/n-connect/program…
Supported by an Independent Educational Grant from AstraZeneca. In Spain, the information displayed is exclusively directed to Healthcare Professionals empowered to prescribe or dispense medicinal products. Please do not distribute in media, supporting materials or communication channels aimed at the general public. This content is intended for HCPs only.
#MedEd #GIcancer #gastric #GEJ #OncTwitter #Medtwitter #ESMO26 #crcsm #pancan #HCC
Ricardo Carvalho 🇧🇷 retweeted
We are all done with #ESMO26! 10+ studies that were on our radar and the updated data around them.
Out in the community settings, it’s tough to keep up with all that is happening here in the world of cancer (and this was just ONE conference). Really appreciate you all sharing the data and importantly your take around this: @OncoAlert @weoncologists @DrChoueiri @StephenVLiu @SuyogCancer @dr_yakupergun @drsarahsam @PTarantinoMD @GIMedOnc @BijoyTelivala @RenoHemonc @nlindenberg @jryckman3 @ErikaHamilton9 @myESMO @LorenzaRimassa 🙏🏽🙏🏽
2 wks to #ESMO26! Here’s a📝of🔑studies for GeneralOnc that could change/reinforce SoC:
- #INTerpath001
- #VOLGA
- #ANZUP1801
- #LITESPARK011
- #DeLLphi305
- #SAFFRON
- #CLARITYGastric01
- #MOIO
- #TroFuse005
- Breast Ca Updates
#OncTwitter @myESMO @OncoAlert
Ricardo Carvalho 🇧🇷 retweeted
ACTICCA-1 trial: Adj. GemCis vs standard of care after curative intent resection of BTC
#ESMO26 #ESMOAmbassadors
👉 DFS at 2yrs: 52 vs 44%
👉mDFS: 23.3 vs 20.6
👉 mOS: 58 vs 48 mo
👉expected toxicity for the doublet
🧐 Trend for OS benefit, not an option for all, but may be considered as option for selected pts
@myESMO @ASCO
Ricardo Carvalho 🇧🇷 retweeted
2. MOIO: PhIII, non-inferiority of reduced-frequency (q3mo) vs standard IO in responders with advanced cancer
- PFS 25 vs 21.9 mo (HR 1.35)
- Death HR 2.0
- No clear safety gain. This is disappointing to see. We need more guidance on who we can de-escalate IO for.
3/5
#ESMO26 Dr. Jarushka Naidoo @DrJNaidoo with a fantastic discussion on de-escalation trials in oncology. A call out on why de-escalation studies are important and their limitations. And for MOIO in particular - lessons on trial design, non-inferiority, and pragmatism. A must-listen to all involved in trial design. #ESMOAmbassadors
Ricardo Carvalho 🇧🇷 retweeted
My takeaway: compelling survival results supporting further expansion of biomarker-directed treatment. Sone-Ve is going to be incorporated in 3L+ and likely earlier; sequencing after immunotherapy and prior CLDN18.2-directed treatment needs further clarification, yet overall very consistent results.
🤖 Made with AI
Ricardo Carvalho 🇧🇷 retweeted
CLARITY-Gastric01 at #ESMO2026: a significant overall survival benefit with sonesitatug vedotin (Sone-Ve), a CLDN18.2-targeted ADC, in previously treated advanced gastroesophageal cancer.
This global phase III trial compared Sone-Ve with investigator’s choice of therapy:
• Third line and beyond: Median OS 10.0 vs 5.0 months, HR 0.47 (95% CI 0.36–0.62), meeting the primary OS endpoint.
• Overall second-line-and-beyond population: Median OS 10.6 vs 6.4 months, HR 0.58 (95% CI 0.47–0.73), a key secondary endpoint.
• PFS by blinded central review did not reach statistical significance: 4.2 vs 3.8 months, HR 0.77. Understanding the OS–PFS discordance remains important.
• Safety: Grade ≥3 treatment-related adverse events occurred in 36.4% vs 44.8%, although grade ≥3 gastrointestinal toxicity was higher with Sone-Ve: 11.1% vs 6.3%.
Testing thresholds matter: Enrollment required CLDN18.2 membranous staining in ≥25% of tumor cells at any intensity, making it much broader. Zolbetuximab eligibility uses ≥75% with moderate-to-strong staining. “CLDN18.2-positive” needs an assay-specific, treatment-specific definition.
#GastricCancer #GIOncology #PrecisionOncology
Ricardo Carvalho 🇧🇷 retweeted
Phase 3 data of subcutaneous anti-PD-L1 envafolimab plus GEMOX in advanced #BTC in China.
#ESMO26
#ESMOAmbassadors
@myESMO
Ricardo Carvalho 🇧🇷 retweeted
Ricardo Carvalho 🇧🇷 retweeted
Perioperative chemotherapy and stereotactic body radiotherapy versus perioperative chemotherapy alone in patients with high-risk, localised pancreatic cancer (MASTERPLAN): an open-label, phase 2, multicentre, randomised trial of the Australasian Gastro-Intestinal Trials Group
#cancer #oncology #MedX #ESMO26 @OncoAlert
thelancet.com/journals/lanon…
Ricardo Carvalho 🇧🇷 retweeted
🚨 3rd Presidential Session at #ESMO26!
Can we safely reduce the frequency of immunotherapy in advanced solid cancers? The phase III MOIO trial tested 12-weekly versus standard immune checkpoint inhibitor administration in responding patients.
⚠️ Unexpected and concerning OS results!
📉 PFS: HR 1.35 (96.16% CI 0.90–2.04)
🚨 OS: HR 2.04 (95% CI 1.08–3.85), favouring standard treatment!
The trial stopped enrolment early following an unexpected OS imbalance.
Key message: De-escalation is attractive, but less treatment is not necessarily better! I want to congratulate the authors anyway to run such important study .
More follow-up is essential.
#ESMO26 #ESMOAmbassadors #Immunotherapy #MOIO #CancerResearch
Ricardo Carvalho 🇧🇷 retweeted
🚨 3rd Presidential Session at #ESMO26!
💉 Can we safely reduce the frequency of immunotherapy in advanced solid cancers?
The phase III MOIO trial tested 12-weekly versus standard immune checkpoint inhibitor administration in responding patients.
⚠️ Unexpected and concerning results!
📉 PFS: HR 1.35 (96.16% CI 0.90–2.04)
🚨 OS: HR 2.04 (95% CI 1.08–3.85), favouring standard treatment!
The trial stopped enrolment early following an unexpected OS imbalance.
A superb and thought-provoking discussion by @DrJNaidoo
Her key messages:
-Statistically inconclusive , but clinically reassuring? Certainly not!
-Non-inferiority margins matter! Would we really be comfortable accepting a potential 30% increase in the hazard of progression simply to reduce treatment frequency?
-One size does not fit all! Different tumour types, different immunotherapy regimens, different biology. Can a pan-tumour de-escalation strategy really work?
-Pragmatic does not mean compromising scientific rigour.
The take-home message: De-escalation remains an important goal, but it must be biologically justified, clinically meaningful and supported by robust evidence.
Doing less is only progress if we can demonstrate that patients are not paying the price in efficacy or survival.
👏 Congratulations to @DrJNaidoo for an outstanding discussion!
#ESMO26 #ESMOAmbassadors #Immunotherapy #MOIO #DeEscalation #Oncology
Ricardo Carvalho 🇧🇷 retweeted
Final analysis LEAP012 unresectable #HCC TACE +Len/Pembro v TACE
➡️mPFS 14.6 v 10.2 HR 0.7
➡️ORR 71 v 49% by mRECIST
❎mOS 40.4 v 40.6; ~1/3 in both subsequent tx
❎much higher gd3/4 TRAEs 71%v31%
➡️❗️1/3 BCLCA
➡️Role combo unclear consistent -ve OS
@myESMO #ESMO26 @OncoAlert
Ricardo Carvalho 🇧🇷 retweeted
Early-onset colorectal cancer (EO-CRC) is increasing globally.
In The Lancet Regional Health - Eastern Mediterranean, authors assessed the burden, temporal trends, and future projections of EO-CRC across the WHO Eastern Mediterranean Region: spkl.io/60147kJDg
Ricardo Carvalho 🇧🇷 retweeted
🧑🔬I recently posted data from G-HOPE-001 and CLARITY-Gastric01, two phase 3 trials evaluating their respective ADCs in previously treated CLDN18.2-positive gastric, GEJ, or esophageal adenocarcinoma.
🧐 Can you spot the differences between arcotatug tavatecan and sonesitatug vedotin?
Btw, pay attention to the interesting design trade-off between retaining versus silencing the antibody’s Fc region.
😲Non-Fc-silenced ADCs (sonesitatug vedotin): Because ADCC and CDC provide an additional mechanism of tumor-cell killing, this ADCs may retain activity even in tumors with lower levels of CLDN18.2 expression.
- Trade-off: Preserving Fc activity may also increase the potential for immune-mediated toxicity, particularly because normal gastric mucosa expresses CLDN18.2.
🤐Fc-silenced ADCs (arcotatug tavatecan): Without additional ADCC/CDC-mediated killing, the ADC depends more heavily on target binding, internalization, and intracellular payload release. As a result, higher levels of CLDN18.2 expression may be needed to achieve sufficient payload delivery and tumor-cell killing.
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-ADC (Antibody-Drug Conjugate)
-ADCC (Antibody-Dependent Cell-Mediated Cytotoxicity)
-CDC (Complement-Dependent Cytotoxicity)
-Fc (Fragment Crystallizable region)
-ILD (Interstitial Lung Disease)
#GastricCancer #CLDN182 #ESMO26 #GIOnc
Ricardo Carvalho 🇧🇷 retweeted
LEAP-012 study of lenvatinib + pembrolizumab vs plc with TACE for HCC: Long-term OS results
#ESMO26 #ESMOAmbassadors
👉ORR: 48 vs 33.7%
👉 mPFS: 14.6 vs 10.2 mo
👉 mOS: 40.4 vs 40.8 mo
🧐 Higher ORR & PFS did not translate into OS, a bit disappointing
@myESMO @ASCO
