Unfair comparison of ITT R0 in FLOT vs R0 of those going to surgery in CROSS. Also,Why compare surrogate endpnts of OS when we actually have the OS to compare? The controlled studies are coming.Will be some disappointed folks likely. See here: meetinglibrary.asco.org/record/167399/… Santhosh Ambika

ILSON David Santhosh Ambika Do you call the benefit of CROSS over surgery alone ‘modest’ with a HR of 0.75? FLOT had HR of 0.76 over ECF which previously had a HR of 0.74 over surgery alone. There is nothing more to say. Ultimately you either see it and it is obvious or you dont. But you eventually will.

ILSON David Santhosh Ambika I guess we must agree to disagree until we see prospective phase 3 data. Thankfully others have actually done this study and asked this very pertinent question as to the utility of RT in EGJ AC and not danced around it for 20+ years. Would you change your opinion based on esopec?

Looking forward to debating Dr Ilson!! (FLOT vs CROSS #31.)Axel Grothey ILSON David

Hey #medtwitter, I need some help with the math on this one: OncoAlert If B - A = X & C - A = X & B=C & D - B = X & D - C = Y Can we solve for Y?

#justmath I particularly like the comment that this is homework for 9-yr olds...German Biotech CROSS-trial comparisons r tricky, but it's the HR compared to controls that are useful here... Of course we await ESOPEC, but for now, the evidence points in a certain direction...no?

Dr. Nina Niu Sanford Dr Amol Akhade Tweet 6/6: From tweet 5/6, if we have a prospective study that seeks organ preservation, documents differences in QOL, & risk of local/distant recurrence & OS comparing dCRT vs, hopefully what is now everyone’s standard, perioperative FLOT, then great, & pts can make a choice.

Dr. Nina Niu Sanford Dr Amol Akhade Last, I would say that ~90% of pts will have a PET response w FLOT, & we saw this also w FOLFIRINOX. These pts are not at risk for R1 resection. One might consider CROSS for those ~10% who don’t, with the caveat that those are the resilient tumors that may also be radioresistant.

IKF-575/#RENAISSANCE phase III Addressing #oligometastatic #GEA more aggressively, my heart said yes, but my brain said no:

@mmeatock Yes research warranted, not SOC. Control here arm did very well compared to overt stage IV disease, as expected, since these are highly selected patients. This control arm is so critical because it normalizes and shows that they do well, but not due to the surgical intervention.

🔥 ASCO 2024 Plenary: Prof Dr Jeroen Dekervel (UZ Leuven) and Prof Dr @FlorianLordick (University of Leipzig) discuss the ESOPEC trial, comparing FLOT perioperative chemotherapy with neoadjuvant chemoradiotherapy for adenocarcinoma of the oesophagus or oesophagogastric junction.

Thank you for this very pivotal study to streamline perioperative therapy for esophageal and gastroesophageal junction adenocarcinoma. #ESOPEC

🚨PRODIGE23🚨 Long term results now published! T3-4 rectal adenocarcinoma Randomized: CRT➡️🔪➡️FOLFOX mFOLFIRINOX ➡️ CRT➡️🔪➡️FOLFOX ✅✅✅Improved OS!!! Looking forward to JANUS clarifying if TNT with FOLFIRINOX vs. FOLFOX improves cCR and/or DFS/OS pubmed.ncbi.nlm.nih.gov/38986769/

#TOPGEAR @ESMO2024 - periop chemo +/- RT for #GEA - no benefit adding RT - now 6 Phase 3 studies w/o CRT benefit vs or added to neoADJ/ADJ tx for GEA: - CRITICS, ARTIST1, ARTIST2, neoAEGIS, ESOPEC, TOPGEAR - SOC is periop #FLOT for all GEA

Better late than never, I guess.

newsroom.astellas.us/2024-10-18-Ast…

#MATTERHORN Phase III FLOT + durvalumab or placebo #dejavu #samsara

#CM577 If only we could have known years ago, maybe we could’ve spared all those patients ineffective (worse than nothing?), toxic expensive therapy.