Immunotherapy with perioperative chemo in locally advanced, resectable GE cancers 2 phase III RCTs, MATTERHORN & KEYNOTE-585 with FLOT4 No significant difference in EFS was between the FLOT-durvalumab and FLOT-pembrolizumab arms FLOT-IO superior to Cis/5Fu-IO Matterhorn OS ?

Adjuvant Anti-Inflammatory Rx in Postop Colorectal Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials 5 trials NSAIDs improve DFS in resected CRC Aspirin=Best PI3K mutations predict best risk reduction with NSAIDs No impact on OS No ↑ in Major AE

Liquid Biopsy - ctDNA -Circulating cell-free DNA Approach= Tumour informed Vs Tumour agnostic Various potential applications for circulating tumor DNA (ctDNA) detection during a disease course of cancer patients. ctD 2 main methods for detecting ctDNA: -Digital PCR -NGS

Finally Lazer-Amivantanab delivers an ACE NEJM

SABR: Uncommon Primary RCC ccRCC (n=167) or nccRCC (n=44) 2007-2021 from 16 institutions in Australia,Canda,Germany, Japan,USA nccRCC were more likely to be treated with multifractuonnand Higher BED (94.8Gy) Vs 87.5Gy for ccRCC. 5y LF=1.5%(ccRCC) vs 2.4%(nccRCC) 5yDF=6% Vs 2.9%

Secondary Cancers = Bladder and Rectal following Sx Vs RT in Prostate Cancer pts SEER Database (2004–2020) N=251,838 110,239 (44%)=EBRT versus 141,599 (56%) = Surgery 10y incidence of secondary BCa (0.9 vs 1.9%) 10y incidence of secondary RCa (0.8 vs 1.5%)

Evolution of Adjuvant RT: Pancreatic Cancer Even Ro Pancreatic resection= Recurrence Rate =70-80% with dismal 5y results =20-30% 1/3rd= Local relapse Adj RT Vs Adj Chemo favouring mFOLFIRINIX:2025 Question: Integrate RT in Neoadjuvant or Adjuvant SBRT Dose escalation ctDNA

Occupational Exposure to Ionizing Radiation in Female Physicians & Breast Cancer Risk 6 observational studies were included, with 34744 participants: 8103 exposed to ionizing radiation and 26641 controls, with min 10y FU There is ↑ risk of breast cancer, with an OR of 1.84

Rebiopsy in mNSCLC in Oncogenic Driver Progression After Optimal Targeted Therapy. Whats Clinical Impact ? See OS 30-40% Literature 50%=Good Challenges Pt refusal,difficult access, deteriorating ECOG PS,poor motivation of Oncologist,Cost Insufficient material Inconclusive Result

Adjuvant EGFRi in Stage 1 resected NSCLC ? Retrospective Single centre 819 Chinese pts JAN'17-20 gefitinib(250 mg OD), erlotinib (150 mg OD),icotinib (125 mg tds), osimertinib(80 mg od),ametinib (110 mg of)& vometinib (80 mg od) Till relapse or 3y pt choice RFS improve OS not