Bijoy Telivala

“How do you pick your front line treatment option”? This question was asked by multiple different community colleagues. @montypal: “There is no wrong answer…” and here is the data for IO/IO or IO-TKI in 1L metastatic #KidneyCancer #GUSM #OncTwitter

🚨 Karyopharm Therapeutics filed for Chapter 11 bankruptcy protection on November 2, 2026, and announced a proposed merger with Ayrmid Ltd. #mmsm #myeloma #MedEd #medtwitter #USMIRC @USMIRCNEWS @OpenMedKate @Larvol @US_HMC @oncodaily

FT Exclusive: CVS Health is plotting a break-up of its $117bn healthcare empire, separating its retail pharmacy chain from its insurance business in what would be one of the largest corporate splits of all time. ft.trib.al/ZlfmGt9

For 2027, CMS is proposing another reduction in physician payments while increasing hospital facility payments. Over the last 20-plus years, physician payments have lost ground to inflation. Hospital outpatient payments, meanwhile, receive regular inflation-based updates. For a routine level 3 visit, the proposed changes are: Independent office: about $95 → $93. On-campus hospital clinic: about $193 → $200–$204, including physician and facility payments. In my office, that $93 has to cover my time, staff, rent, equipment, EMR and billing. The physician payment in the hospital falls too. The increase comes from the separate facility fee. Independent practices face rising overhead without a separate facility payment to offset the cut. That makes independent practice harder to sustain and encourages routine care to move into hospitals, where the total payment is more than twice as much.

If/when VOLGA regimen is approved, is this something (3 cycles of EV-Durva) you’d extrapolate for cis eligible MIBC patients as well and use this approach broadly or stick with EV-Pembro (EV304: and push for 9 cycles of EV)? @PGrivasMDPhD @shilpaonc @drenriquegrande @DrKarineTawagi @UroDocAsh @bergsa83 @MikeSerzanMD @BrendanGuercio #ESMO26 @tompowles1 @dr_yakupergun @DrYukselUrun

ESMO 2026 presidential 2 | HARMONi-GI1: Ivonescimab beats durvalumab in advanced biliary tract cancer! Phase III trial (n=682): Ivonescimab (PD-1/VEGF bispecific antibody) + gemcitabine/cisplatin vs durvalumab + gemcitabine/cisplatin in 1L advanced BTC. 📊 Key results: ✅ Median OS: 14.9 vs 12.1 months (HR 0.75; p=0.0031) ✅ Median PFS: 8.4 vs 5.8 months (HR 0.61; p<0.0001) ✅ ORR: 53.8% vs 32.5% (p<0.0001) ✅ Manageable safety profile; no new safety signals. 🔥 25% reduction in risk of death and 39% reduction in risk of progression! A rare head-to-head phase III victory against an established immunotherapy standard in BTC. Could PD-1/VEGF bispecific antibodies replace conventional PD-L1 inhibition in first-line BTC? @OncoAlert @myESMO #ESMO26 #BiliaryTractCancer #Oncology

For the final act of CheckMate 8HW, we finally have the significant OS data the doubters have been asking for. What happens when you have a great treatment and an even better one for a study (and almost everyone crosses over)? You have to wait a really, really long time for OS. Also, some thoughts on splitting the alpha I won’t get into here. Nivo/ipi vs nivo alone vs chemo, MSI-H/dMMR mCRC. Final OS analysis. Response rate 72% with nivo/ipi, 58% with nivo alone. 
Median OS still not reached. 
OS HR 0.66 for nivo/ipi over nivo, statistically significant. 
77% of nivo/ipi patients alive at 5 years. Three out of four patients alive at five years. In metastatic colorectal cancer. 🤯 Not even going to talk about the chemo arm. It's clearly worse, and there is never a time to give chemo in MSI-H unless someone has extreme, active autoimmune disease. “Debulking” is absolute nonsense. Bottom line: the doubters got their OS. Nivo/ipi is the first-line standard for MSI-H mCRC. Next steps: how do we decide length of therapy, and how do we manage oligometastatic progression? #ESMO26
@OncoAlert @TheGutOncLab @OncoAlert

#ESMO26 | IROCAS I think we can finally put this debate to rest In high-risk stage III colon cancer, intensifying adjuvant chemotherapy with mFOLFIRINOX failed to improve DFS over mFOLFOX6 We need to rethink our approach to treatment escalation in the adjuvant setting. Simply adding more conventional cytotoxic agents is not the answer.

3. DASL-HiCaP: PhIII, Darolutamide + ADT + RT in very high-risk PCa (n=1106, incl BCR post-RP) - 4y MFS-CI 95% vs 88% (HR 0.42) - OS immature - ARPIs will play a bigger role in early prostate cancer (DASL-HiCaP & PROTEUS) 4/5