Oncology. Radiotherapy. Science. Development.
Pamplona, Spain
Joined August 2010
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Ignacio Visus retweeted
Happy to share that our multicenter, randomized, sham-controlled phase II trial of low-dose whole-brain radiotherapy in mild-moderate Alzheimer’s disease is now published in Radiotherapy & Oncology!
Why we did it: LDRT reduced amyloid and neuroinflammation in AD mouse models. Our two dose arms came from early human reports: a CT-dose case report (0.04 Gy; Cuttler et al., 2016) and a single-arm pilot (0.5 Gy; Kim et al., ROJ 2023). Neither had a control group.
What we did: 41 amyloid-PET+ patients were randomized to sham, 0.24 Gy, or 3 Gy (6 fractions over 3 weeks), on top of standard medication.
What we found:
- 6-month ADAS-cog (primary endpoint) was not met
- 12 months (exploratory), −5.4 points with 3 Gy (nominal p = 0.044), though findings were not consistent across other outcomes. No treatment-related adverse events.
What’s next: LDRT was safe, but efficacy is not established. Larger, adequately powered trials with longer follow-up are needed, and we look forward to LDRT-MIND from Dr. Evan Thomas, which will add more robust data and explore maintenance.
Grateful to our patients, and co-investigators across three centers.
🔗 doi.org/10.1016/j.radonc.202…
#Alzheimers #LowDoseRT #ClinicalTrial @EvanThomas84 @jryckman3
Ignacio Visus retweeted
#ESMO26 Day 1 highlight for me: MASTERPLAN, now in Lancet Oncology.
Radiation and pancreatic cancer have a complicated history. ESPAC-1 suggested adjuvant chemoradiation hurt. LAP07 and CONKO-007 couldn't show an OS benefit after chemo. A021501 closed its RT arm for futility. PREOPANC-2 was a draw. We walked through the adjuvant side of this story in Sem Rad Onc last year: doi.org/10.1016/j.semradonc.…
So why is MASTERPLAN different?
Phase 2, 14 sites in Australia and NZ (can i just say I love the Aus-NZ studies). 74 patients with high-risk localized PDAC, randomized 2:1 to chemo ± SBRT 40 Gy/5 after induction.
12-mo locoregional recurrence 20.2% vs 52.0%, sHR 0.44, p=0.022
PFS 11.9 vs 6.3 mo, HR 0.44
OS 22.0 vs 14.0 mo, HR 0.45
Grade ≥3 AEs 70% vs 64%.
Why did this one work when others didn't? The rad oncs can explain the physics better than I can. I just read it as better tumor zap zap.
Does it change practice? Maybe. I think we need to have a deeper conversation at every tumor board, but the juice seems worth the squeeze.
@OncoAlert @TheGutOncLab @Onco_Nexus
sciencedirect.com/science/ar…
Ignacio Visus retweeted
🔥AGITG MASTERPLAN🔥
Borderline resectable or Locally advanced PDAC
n=75
🔍Randomized
3m mFOLFIRINOX or Gem+nab-Paclitaxel alone +/- SBRT (40 Gy/5 fx)
Primary endpoint: locoregional recurrence
🚨SBRT had improved:
✅12 m LRR: 20% vs. 50%
✅mOS 22m vs. 14 m
#ESMO26
Ignacio Visus retweeted
ConCERT Trial Ph III randomized noninferiority trial comparing weekly cisplatin with q3w during definitive RT for locally advanced head and neck SCC.
Cisplatin 40 mg/m² weekly Vs Cisplatin 100 mg/m² q3w
N=278
Primary End Point
2yLR 61.3% Vs 51.1% (+10.2%)
Gr3 Toxicity worse 3w
Ignacio Visus retweeted
⚡️ Phase 2 trial in RCC with inferior vena cava tumor thrombus: neoadjuvant stereotactic ablative radiotherapy (SAbR) followed by surgery (n=23).
1-year recurrence-free survival: 71.4% — above the 55.7% historical benchmark. Thrombus downstaging in 22%.
A promising approach for one of the most challenging complications in kidney cancer.
#KidneyCancer #RCC @JAMAOnc
jamanetwork.com/journals/jam…
Ignacio Visus retweeted
..we do know that patients getting SBRT with fiducials on a standard linac had more GU AEs recorded pubmed.ncbi.nlm.nih.gov/4113…
Ignacio Visus retweeted
🚨 Radioligand therapy before SBRT in oligorecurrent #prostatecancer 🚨
@EuropeanUrology - LUNAR trial
👥 n=92 orHSPC, 1-5 PSMA PET-detected lesions
📊 RCT phase 2 LUNAR, 2 cycles neoadjuvant 177Lu-PNT2002 then SBRT vs SBRT alone
⏱️ Median f/u 31.9 mo
✅ PFS 17.6 vs 7.4 mo, HR 0.38 (0.23-0.61), p<0.001
✅ ADT-free survival HR 0.57 (0.34-0.95), p=0.03. NED at 24 mo 33% vs 12%, p=0.02
✅ Exploratory: polymets-PFS HR 0.28, Castration-resistant-FS HR 0.13, CT-PFS HR 0.46
⚠️ Secondary/Exploratory endpoints, wide CIs, small n. PSMA PET-defined events carry lead-time bias
🎯 Adding 177Lu before metastasis-directed SBRT may delay castration resistance and polymetastatic spread
🔗 doi.org/10.1016/j.eururo.202…
@AmarUKishan @JeremieCalais @UCLAUrology @PCF_Science @UrologyTimes @urotoday @UroOnc
Ignacio Visus retweeted
Placebo Controlled Randomized Trial: Memantine given w/Brain RT Improved Cognitive Outcomes & QOL 1/3 sciencedirect.com/science/ar…
Ignacio Visus retweeted
#ASTRO26: In PSMA-PET+ oligometastatic prostate cancer, adding SBRT to iADT showed:
📉 3-yr biochemical progression: 21% vs 60% (p=0.004)
⏱️ Time to progression: NR vs 27 mo
🔄 ADT re-initiation: 18% vs 41% (p=0.06)
📊 No significant QoL difference
Promising signal for MDT!
🤖 Made with AI
Ignacio Visus retweeted
#BladderCancer #TMT
#ASTRO26
@ASTRO_org
Guidelines by @drjefstathiou and team
Key message
Radiotherapy is a critical component of bladder cancer care.
For selected patients with MIBC (cT2–4aN0M0), trimodality therapy is a guideline-supported alternative to radical cystectomy — combining maximal TURBT, concurrent radiosensitization and RT.
🎯 Bladder preservation is not a compromise. It is an evidence-based treatment strategy.
Ignacio Visus retweeted
GETUG P05: Ph 3 RCT of 46 Gy EBRT + LDR/HDR brachy boost vs dose-escalated 80 Gy EBRT in IR PCa, no ADT (n=288)
🔹5-yr bPFS: 88% vs 88.2% (p=0.90)
🔹No bPFS benefit in iether GG2 or 3 pts
🔹5-yr OS: 96% vs 92.7% (p=0.30)
🔹Acute GI toxicity lower w/ brachy: 30% vs 41% (p=0.03)
🔹Late GU toxicity higher w/ brachy: 82% vs 64% (p<0.01); G2: 34% vs 18%; G3 remained low: 3% vs 1%
🔑 Brachy boost did not improve biochemical control or OS but increased late urinary morbidity → modern dose-escalated EBRT remains the standard non-invasive option for IR PCa
@urotoday
#ASTRO26
Ignacio Visus retweeted
Dr. Paul Brown: “It’s time to say thanks to PCI for its service.”
#ASTRO26 @PDBrownOnc
Ignacio Visus retweeted
Clinical trials session packed for some amazing trial data including long term clinical and functional outcomes for LDRT for knee osteoarthritis. Great work coordinating the publication of this data @KoneruMd !
#ASTRO2026
Ignacio Visus retweeted
Controversial statement by @SJFrankMD, informed by the ProtecT study results, for those who still think prostatectomy is the better treatment. #ASTRO26
Ignacio Visus retweeted
Imagine if we compared #brachy boost to SBRT?!?
Will never get those data for FIR patients.
@CDNCancerTrials PR24 is comparing brachy vs SBRT boost for UIR/HR/VHR prostate ca pts. Just passed 300/710 accruals!
I’ve been saying this for years…
Now we have randomized data.
GETUG P05: brachytherapy boost vs dose-escalated EBRT in intermediate-risk prostate cancer.
Oncologic outcomes similar but far more toxicity with brachy.
#ASTRO26 #ProstateCancer
@ASTRO_org @NehaVapiwala @AmarUKishan @DrAndrewLoblaw @seanmmcbride @HimanshuNagarMD @TylerSbrt @seanmmcbride @alison_tree @Soum_Roy_RadOnc @NicholasZaorsky @angela_jia_
Ignacio Visus retweeted
The Varian Users Meeting was one of the highlights of the day. I mean look at this awesome holographic reveal of the new Accela unit! Multi lesion targeting @ 10 Gy each in under 30s. Full imaging to delivery workflows in under 90s. The future is really here! #ASTRO2026
Ignacio Visus retweeted
OPEN trial
Can an open-face thermoplastic mask, when combined with SGRT, maintain H&N RT setup accuracy while improving patient experience ?
prospective, randomized phase III, 1:1:1 trial conducted at two radiotherapy centres
N=200 pts
Landmark trial incorporating OPEN masks
