Jp Solar Vasconcelos @jaypsv

🧬 FIND (Phase III) | Resected CRC 🩸 ctDNA-guided surveillance vs standard CT ⏱️ Earlier recurrence detection: 3.9 mo 🎯 Curative-intent treatment: 48.1% vs 23.6% 🫁 Curative resection of liver/lung recurrence: 42.3% vs 18.2% 💡 More curative opportunities; survival benefit remains unproven. 🔗 doi.org/10.1200/JCO-25… @OncoAlert

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Durante décadas, la medicina asumió que el principal desafío era descubrir nuevos tratamientos. Pero este paper plantea una idea mucho más incómoda: quizá el problema no es que falte conocimiento, sino que los sistemas de salud son extraordinariamente malos para usar el que ya tienen. La llamada “ciencia de la implementación” parte de una observación casi absurda en apariencia: pueden pasar hasta 15 o 20 años entre un descubrimiento clínico sólido y su adopción rutinaria en hospitales. En ese intervalo, millones de pacientes reciben atención basada no en la mejor evidencia disponible, sino en inercias institucionales, hábitos profesionales y limitaciones estructurales. El artículo tiene el mérito de aterrizar esta discusión sin excesivo tecnicismo. Su mensaje es simple pero profundo: una terapia eficaz en un ensayo clínico no necesariamente sobrevivirá al mundo real. Allí aparecen variables mucho menos elegantes que las estadísticas biomédicas: burocracia, agotamiento del personal, falta de recursos, cultura organizacional y resistencia al cambio. Y quizá ahí reside la parte más interesante del paper. La medicina contemporánea suele celebrar el descubrimiento, la nueva molécula, el biomarcador, la tecnología disruptiva, pero rara vez presta la misma atención a la logística humana que determina si esos avances realmente llegan a las personas. En otras palabras, salvar vidas no depende únicamente de innovación científica; depende también de sistemas capaces de implementar esa innovación de manera consistente. El artículo sugiere que la próxima gran revolución biomédica podría no provenir de laboratorios futuristas, sino de algo menos glamoroso y mucho más difícil: aprender cómo transformar instituciones complejas, rígidas y profundamente humanas. pmc.ncbi.nlm.nih.gov/articles/PMC12…

STELLAR Trial (JCO 2026): 5-Year Update • SCRT-based TNT improved 5-year OS (78.1% vs 69.7%; HR 0.74). • No significant DFS difference, highlighting an OS benefit despite similar DFS. • Greatest benefit was seen in ESMO high-risk patients. • Late watch-and-wait regrowth (5–7 years) supports prolonged surveillance. • Adds important long-term evidence to the TNT era alongside RAPIDO and PRODIGE 23. Will these results change your preferred neoadjuvant strategy for LARC? #RectalCancer #LARC #TNT #JCO #Oncology #MVOnco

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Strategy I use for calming myself when feeling overwhelmed. I remind myself I’ve been here before and always made it through without catastrophe – if I just keep plugging away, I’ll make it through again. Same experience? – may be useful to you.

Existe um gráfico que circula no Vale do Silício comparando dois caminhos: uma sequência de verdades duras leva a um sistema funcional. Uma sequência de mentiras gentis leva a um sistema disfuncional. Tony Fadell, co-criador do iPod e do iPhone, diz que essa é a distinção mais subestimada em times de produto.

Caraca, como a Emily Wilson DETONOU ''A Odisseia''. É de Wilson a tradução q o diretor leu pra fazer o filme. Já no primeiro parágrafo, ela manda: ''Ao contrário, de outros filmes de Nolan, este não é chato. É q é difícil estragar o material original''. lrb.co.uk/the-paper/v48/…

[¹⁷⁷Lu]Lu-edotreotide versus everolimus for gastroenteropancreaticNET (COMPETE) @TheLancet doi.org/10.1016/S0140-… 👉 ORR: 22 vs 4% 👉 mPFS: 23.9 vs 14.1 mo 👉 mOS: 63 vs 58 mo 🧐 Support PRRT as effective 2nd line treatment @myESMO @ASCO

A high-yield summary of pancreatic tumors; location, histology, and molecular alterations in one page. Hope it helps trainees and board candidates!

DO NOT HOLD DOORS has no vowels besides O, and its word lengths increase sequentially

🦓Well-differentiated NETs can change Review on NEN transformation by @UGrewalMD 🔬Rising Ki-67 + TP53 (±RB1) →NEC-like behavior on a NET backbone 🔑Old info can mislead decisions 🎯Implication: re-biopsy the progressing lesion, re-profile, re-image doi.org/10.1530/ERC-26…

Two excellent back to back papers from @Flinders demonstrating improved quality of life and bowel function overall with Watch + Wait vs Surgery in patients with rectal cancer. Links in comments.

🧬 GI Oncology Digest - July 24, 2026 (yes, I'm late) A colorectal-heavy week, and a strong lead: 🎯 A positive PHASE III in high-risk rectal cancer - intensified TNT improves disease-free survival 🏃 CHALLENGE follow-up: structured exercise isn't just effective, it SAVES money 💊 Aspirin in CRC gets sharper - the PIK3CA exon 9/20 biomarker story A thread 🧵👇 #GIOnc #CRC #RectalCancer

🧬 Zolbetuximab hypoalbuminemia ⏱️ Early onset (peak C1-C3) ⚠️ Grade 3: 21% 💧 Edema: 100% | 🍽️ Anorexia: 93% | 🫧 Ascites: 60% 🔄 Usually reversible ✅ Rechallenge often feasible ➖ No clear impact on efficacy 🎯 Check albumin closely first cycles 🔗 doi.org/10.1016/j.esmo… @OncoAlert

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A rule that saves a lot of pain: When emotions are high, speed should be low. You don’t have to answer the email immediately. You don’t have to respond to that slight. You don’t have to make that decision. You don’t have to do anything. Slow down. Create space to think clearly.

🧬 dMMR/MSI-H GI cancers treated with ICIs 🌍 1,175 pts | 34 centers ⚠️ Grade ≥3 irAEs: 10% 📈 Higher ORR: 48.6% vs 34.6% ➖ No PFS / OS benefit 🔄 Recurrence after ICI rechallenge: 57.1% 🎯 ICI rechallenge should be carefully selected 🔗 jitc.bmj.com/content/14/7/e… @OncoAlert

Bile acid diarrhea (BAD) and bile acid malabsorption (BAM) are common among patients with neuroendocrine tumors and diarrhea. One study (Khanna et al. PMID: 34365537) reported that among NET patients with diarrhea, >90% had BAM present (not necessarily the sole cause of the diarrhea) and the length of ileal resection did not matter. Surprisingly, BAM was very common among patients with no prior ileal resection. BAM is challenging to diagnose but with the availability of the Bile Acids Malabsorption Panel (BAMRP) available at Mayo Laboratories, it is getting easier (link in comments). It this study, led by Dr. Michael Camilleri of Gastroenterology at Mayo Clinic, BAM was present in 60% of patients with NETs and diarrhea as assessed with the BAMRP, lower than the previously reported >90% but that was documented by different methodology, 48-hr stool collection which is understandably unpopular among all involved... The other method often quoted, the SeHCAT, is not available in the US. Many patients in this study had coexisting elevation of plasma 5HIAA suggesting concurrent carcinoid syndrome but others did not. Bottom line: -- BAM is common in patients with NETs and diarrhea -- It often coexists with carcinoid syndrome (and exocrine pancreatic insufficiency from SSAs and/or pancreatic resections) -- It can occur as the sole cause of diarrhea, often in patients with no prior ileal resections -- It is much easier to diagnose now, thanks to the BAMRP panel but maybe not quite as sensitive -- BAM/BAD is highly responsive to bile-acid binding drugs like colestipol -- Diagnosing and treating BAM/BAD can drastically improve the QOL of patients with NETs and diarrhea @sonbol_bassam @PatrickMcGarrah link.springer.com/article/10.100…

My students sometimes ask why they should memorise things in the age of Google and LLMs. But internalised facts are your bullshit filters and your raw material for creative association. Facts outside your head are inert.

🔥off the press🔥 Expanding the path to cure - a narrative review on optimizing multimodality sequencing in HCC 👉HCC management is shifting toward a personalized, multimodal continuum, a 🇨🇦 perspective 👇my author link authors.elsevier.com/c/1nURW15X3~m1… @myESMO @ASCO

True story: This year, Norway beat Brazil in soccer, and Brazil beat Norway in skiing.

How do you deal with grief and loss when your patient dies? Almost feels like a taboo to talk about, but we do grieve when our patients die. And we should talk about it. My latest in @Medscape : medscape.com/viewarticle/mo…