An Australian oncologist with an interest in GU malignancies, phase 1 trials, cycling and having fun with the family
Melbourne, Australia
Joined May 2012
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Media hype, bad headlines & euphemisms mask trial truths. @oncology_bg calls for honesty in trials, press, and the clinic. #CommonSenseOncology is needed #ANZUP25 #EndOfLifeCare
BCG + mitomycin C vs BCG similar efficacy, fewer doses—a smart option in BCG shortage era. Combo looks better in patients with CIS and NMIBC. Early biomarker data & AI analysis may personalise NMIBC therapy #ANZUP25 #NMIBC #BladderCancer
MicroRNA-371 is outperforming traditional tumour markers in germ cell tumours. Australian trials like CLIMATE, PRESTIGE will add to data on surveillance & intensification strategies #ANZUP25
New penile cancer models (organoids & PDXs) from fresh tissue now mimic tumor biology & response. A rare cancer, but with big translational potential. A major leap from Mitch Lawrence #ANZUP25 #GUonc #PenileCancer #TranslationalOncology
🧵 Immune resistance in cancer
🛡️ T-cell exclusion? Target macrophages with PI3Kγ inhibitors (e.g. IPI-549) to open the tumor to immune attack.
Chronic interferon = double-edged sword. JAK inhibition redirects exhausted T cells back into action.
PD-1 + LAG-3 = durable IO ⚡
🚨 IO triplet in RCC hits turbulence
Zanzalintinib + nivolumab = 63% ORR, 18.5 mo PFS
?benefit over Cabo/Nivo ?less HFS but similar activity...
➕ Adding relatlimab (triplet) ➡️ lower ORR & PFS
🔁 Rethink LAG3 as target RCC, it's not melanoma 😞
#ASCO25
5-yr data from KEYNOTE-564 confirms OS benefit for adjuvant #pembrolizumab in high-risk clear cell #RCC (HR 0.66).
DFS & OS gains across subgroups.
🔥 Confirms OS benefit in adjuvant RCC
🧬 But are we overtreating 48% who never recur?
#ASCO25 #GUonc #Immunotherapy
🚨 KRAS G12C in CRC: Combo strategies evolving fast.
🧪 G12C inhibitors + anti-EGFR (e.g. cetuximab) show synergy (ORR ~46%)
💥 Adding chemo may boost activity—but ⏫ toxicity, dose interruptions
📌 Takeaways: – Drug exposure matters
– ctDNA ≠ always concordant
#ASCO25
🧬 New hope for GU neuroendocrine carcinomas: DLL3-targeted T-cell engager shows a 40% response rate & ~8mo durability in DLL3-high tumors— outperforming chemo or IO in this poor-prognosis group. Biomarker-driven therapy may be here for small cell GU. #ASCO25 #OncTwitter #GUonc
#ASCO25 Drug development session: Is HER3 the new HER2—or is it too soon? 🧬
HER3-targeting ADCs show promise in NSCLC & SCLC, but biomarker gaps, resistance issues and payload limits remain.
“It’s not too early, but it’s not yet.” Lillian Siu
What the #ASCO2025 AI session didn't cover fully (otherwise great talks)
1️⃣ Genomic + multi-omic integration platforms
2️⃣ Health equity & bias audit needs
3️⃣ Clinician AI training urgent
4️⃣ Medico-legal liability frameworks for use
5️⃣ Environmental costs of large models ?🔌☢️
Real-world AI in cancer care:
✅ ↑ in end-of-life discussions via AI nudges
✅ Increase nurse time in care (↓ documentation)
✅ Faster trial screening & protein folding breakthroughs
But trust lags behind tech. Transparency, bias control & safety need urgent attention.
#AIOnc
🔍 AI in Oncology #ASCO2025
AI isn’t replacing oncologists—it’s augmenting care. Clinical decision support & ambient scribing to trial matching & drug discovery, AI improves efficiency, nudges evidence-based care, and supports overworked teams. Real challenge? Change management.
Totally disagree with recruitment of patients with liver mets to CRPC trials that have a rotation to a different ARPI. There may be a role for that control arm in patients with PSA only or limited radiological progression...
1/2
Enthusiastic audience response to #ASCO24 plenary abstracts today. Great that the organisers were able to schedule @TimmyTrumpet @tiesto @Alesso for after party
