Alan Tan

#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 https://t.co/FfugtpcYwU

PROTEUS substudy at #ESMO26 presented by Alberto Briganti 🇪🇸 Perioperative apalutamide + ADT vs RP + PLND alone in HR localized/LA prostate cancer (N=408, 1:3) ▪️ EFS HR 0.38 (0.26–0.55), p<0.0001 ▪️ 36-mo EFS 63% vs 41%; SOC median EFS only 19.1 mo ▪️ Benefit held after T recovery @neerajaiims @DrChoueiri @DrRanaMcKay @tompowles1 #ProstateCancer

More PROTEUS results: events, MFS and time to subsequent therapy #ESMO26 https://t.co/88E2f5U9Sk

KEYNOTE-B15 ctDNA analysis presented by Jonathan Chatzkel at #ESMO26, with Min Teo as discussant 🧬 In cisplatin-eligible MIBC, ctDNA+ before surgery meant almost no pCR with either regimen (3.7% with EV + pembro, 2.2% with cis/gem). Among ctDNA− patients, pCR was 72.4% with EV + pembro vs 43.7% with cis/gem. In the EV + pembro arm, patients who cleared ctDNA had 24-month EFS of 81% vs 33% with persistent ctDNA+. The postsurgery results replicate NIAGARA. Serial ctDNA could open the door to bladder-sparing and surveillance questions. #MRD #ctDNA #BladderCancer

More from the B15 ctDNA analysis: pre-treatment and presurgery ctDNA both predicted EFS, consistent with NIAGARA and Christensen 2019, and postsurgery ctDNA+ again identified the highest-risk group. #ESMO26 https://t.co/HdByxX6ZKQ

DASL-HiCaP at #ESMO26, presented by @Niazi_Dr7: darolutamide + RT + 2 yrs ADT vs placebo in very high-risk prostate cancer (n=1,106) ▪️ MFS HR 0.42, 4-yr MFS 95% vs 88% ▪️ PSA-PFS HR 0.47 ▪️ Time to CRPC HR 0.22 ▪️ OS immature (HR 0.88) #ProstateCancer https://t.co/pfDHyuM2qW

DeLLphi-305 at #ESMO26, presented by Jacob Sands, got a standing ovation. An important advance in very aggressive biology. Tarlatamab + durvalumab vs durvalumab as 1L maintenance in ES-SCLC: ▪️ OS HR 0.42, median 21.1 vs 12.7 mo ▪️ PFS HR 0.34 ▪️ ORR 26.4% vs 4.1% Important to study in NEPC and small cell bladder.

CheckMate 8HW final OS at #ESMO26: NIVO+IPI in centrally confirmed MSI-H/dMMR mCRC ▪️ All lines vs NIVO: HR 0.61 (0.46–0.82), p=0.0009; 5-yr OS 74% vs 62% ▪️ 1L vs NIVO: HR 0.66 (0.44–0.99), p=0.043, missed prespecified boundary (p<0.0058); 5-yr OS 77% vs 66% ▪️ 1L vs chemo: OS HR 0.37, p<0.0001 ▪️ Median f/u ~68 mo; safety stable, low grade 3/4 #CRCSM #MSIH

KEYNOTE-B15 ctDNA analysis presented by Jonathan Chatzkel at #ESMO26, with Min Teo as discussant 🧬 In cisplatin-eligible MIBC, ctDNA+ before surgery meant almost no pCR with either regimen (3.7% with EV + pembro, 2.2% with cis/gem). Among ctDNA− patients, pCR was 72.4% with EV + pembro vs 43.7% with cis/gem. In the EV + pembro arm, patients who cleared ctDNA had 24-month EFS of 81% vs 33% with persistent ctDNA+. The postsurgery results replicate NIAGARA. Serial ctDNA could open the door to bladder-sparing and surveillance questions. #MRD #ctDNA #BladderCancer

ctDNA tumor fraction in TALAPRO-3 from @AzadOncology at #ESMO26 🧬 In HRR-deficient mCSPC, baseline ctDNA+ (TF ≥1%) was prognostic for rPFS in both arms. Week 5 matters too: 82% of ctDNA+ patients cleared on TALA + ENZA vs 68% on PBO + ENZA, and clearance tracked with longer rPFS (HR 0.36 vs persistent ctDNA+). Early on-treatment ctDNA could become a real tool for risk stratification and monitoring. Next up is whether it adds value beyond PSA. #MRD #ctDNA #ProstateCancer

BREAKING at #GU26: The Phase 3 LITESPARK-022 study meets its primary endpoint. Adjuvant pembrolizumab + belzutifan significantly improved Disease-Free Survival (DFS) vs pembro alone for clear cell RCC at risk of recurrence: 🔹 HR: 0.72 (95% CI, 0.59–0.87) 🔹 P = 0.0003 🔹 OS data still immature (HR 0.78) Safety: Anemia was the most common AE in the combo arm (84%). #KidneyCancer #RCC #OncTwitter