PTEN loss isn’t just another mutation — it removes the brake on the PI3K–AKT–mTOR pathway 🚦 When AKT is addicted, target the right node. IHC or NGS? Baseline or rebiopsy? Mechanism should guide medicine. #MVOnco #Oncology #PrecisionMedicine

Blocking the same pathway at different levels — output, input, or the engine itself. Everolimus → Broad suppression Alpelisib → PIK3CA-specific Capivasertib → AKT-node precision Match the mutation. Target the dependency. #MVOnco #BreastCancer #PrecisionOncology #MedOnc

In PTEN-deficient mHSPC, adding capivasertib to abiraterone improves rPFS by +7.5 months (HR 0.81) and delays hormonal escape (TTCR HR 0.77). Target the biology — not just AR. #MVOnco #ProstateCancer #mHSPC #PrecisionOncology

• CAPItello-281 PRO data (ASCO GU 2026) • rPFS improved • No clinically meaningful HRQoL decline • Functional wellbeing preserved • Early AKT-related AEs manageable Precision intensification without compromising daily life. #MVOnco #ASCOGU #mHSPC #ProstateCancer

PEACE-3 (ASCO GU 2026) delivers final OS. Enzalutamide + Radium-223: 38.2 vs 32.6 mo (HR 0.75). 25% ↓ risk of death in bone-dominant mCRPC. Systemic + bone-targeted synergy confirmed. #MVOnco #ASCOGU #mCRPC #ProstateCancer

Radium-223 or Lu-PSMA in mCRPC? Bone-dominant disease → Radium-223 (+ Enza now OS-validated in PEACE-3). PSMA+ systemic spread → Lu-PSMA. Alpha vs beta. Bone-targeted vs whole-body. Choose the biology. #MVOnco #ASCOGU #mCRPC #ProstateCancer #Theranostics

PD-L1 <1% in advanced NSCLC? Real-world data (Lung Cancer 2026) show NIVO+IPI+chemo delivers 47.4 mo median OS vs 16.6 mo with PEMBRO+chemo (HR 0.50). No difference if PD-L1 ≥1%. Is dual IO the edge in PD-L1 negative disease? #MVOnco #NSCLC

In muscle-invasive bladder cancer: Urine tumor DNA fell from 85% → 55% after neoadjuvant therapy. If utDNA cleared → much lower recurrence risk (HR 0.24). utDNA− before surgery → 72% pCR. Blood + urine together = better prediction. #MVOnco #BladderCancer #MIBC #ctDNA

KIM-1 in RCC — why should we care? 🧬 It’s a protein released by kidney cancer cells 📈 It may rise before scans show relapse 🧠 It reflects tumor biology, not just tumor size In RCC, biology may speak before imaging. #MVOnco #RCC #KidneyCancer #GUOncology #Oncology

CYTOSHRINK trial looked at adding focused radiation (SBRT) to the kidney tumor along with Ipilimumab + Nivolumab in metastatic kidney cancer. 👉 It was safe. 👉 But it did NOT improve survival or delay progression. #MVOnco #KidneyCancer #RCC #Immunotherapy #ASCOGU #Oncology

Stage I seminoma after orchiectomy 👇 ✔ Reliable follow-up → Active surveillance (preferred) ~15% relapse, salvage effective, survival ≈99% ❌ Not reliable → Carboplatin or RT Choice = follow-up reliability. #MVOnco #TesticularCancer #GUOncology

Stage I NSGCT after surgery 👇 First, check 3 risk factors: • LVI • EC • T3/T4 If none → relapse ~10% If T3/T4 only → ~20% If LVI or EC → relapse ~50% Good news: cure rates ≈99% with all options. #MVOnco #TesticularCancer #NSGCT

TRISST trial (JCO 2022) 👇 In Stage I seminoma on surveillance: • MRI is as good as CT • 3 scans can be as safe as 7 scans • No difference in survival Less radiation. Same cure rates. Smarter, safer follow-up for young men. #MVOnco #Seminoma #TesticularCancer #GUOncology

🧬 What if we had a blood test that detects active germ cell tumor cells — even when AFP & β-hCG are normal? miR-371 is changing how we diagnose and monitor testicular cancer. But remember: it doesn’t detect teratoma. #MVOnco #TesticularCancer #Oncology

Stage 1 testicular cancer: CT scan normal after surgery… but 20–30% still relapse. CLIMATE study shows a blood test (miR-371) can predict relapse risk (HR ~10). Early MRD signal — promising, but needs more validation. #MVOnco #TesticularCancer #Oncology

Is MRD redefining adjuvant therapy? In Stage I TGCT, miR-371 predicts relapse (HR ~10). In Stage II colon cancer, ctDNA helps decide who can safely avoid chemo. From predicting risk to guiding treatment — the MRD era is here? #MVOnco #MRD #Oncology

Relapsed germ cell tumor after multiple lines of chemo — what next? Phase II data shows cabozantinib achieved disease control in 43% of heavily pretreated patients, with strong tumor marker reduction. Not curative, but a meaningful option. #MVOnco #GCT

Residual HER2+ disease after neoadjuvant therapy isn’t equal. Bulky tumor + node-positive = higher risk → consider T-DXd. Minimal residual focus = lower risk → T-DM1 may suffice. Escalate when risk persists. Individualize when it doesn’t. #MVOnco #BreastCancer

Weather changes daily. Climate changes slowly. In oncology, DYNAMIC reshaped colon cancer using ctDNA. Now CLIMATE with miR-371 in testis is guiding smarter decisions. Is the treatment climate becoming dynamic? 🌍🧬 #MRD #Oncology #ASCOGU26 #MVOnco

Cytoreductive nephrectomy in metastatic RCC has evolved. Not routine anymore. Start immunotherapy first. Restage. Operate only on responders. It’s no longer dogma — it’s biology-driven strategy. #RCC #KidneyCancer #Immunotherapy #MVOnco