Axel S. Merseburger

@OncoAlertOct 28

Why ‘More Drugs’ Isn’t Always Better: VOLGA Trial Redefines #BladderCancer Care #Podium2Screen from the #ESMO26 Presidential Session Presented by our @OncoALert 🚨faculty @tompowles1 Perioperative Durvalumab ± Tremelimumab Plus Neoadjuvant Enfortumab Vedotin in Muscle-Invasive Bladder Cancer: Results From the Phase 3 VOLGA Trial @jteoh_hk @CPRT65 🔬 Phase 3 VOLGA trial (n=695) Evaluated perioperative durvalumab (D) ± tremelimumab (T) plus neoadjuvant enfortumab vedotin (EV) versus control (radical cystectomy [RC], followed by observation or approved adjuvant therapy) in cisplatin-ineligible muscle-invasive bladder cancer (MIBC). Just PUBLISHED in @NEJM nejm.org/doi/full/10.1056/NE… Interim analysis; median event-free survival (EFS) follow-up: 22.9 months. ➡️ D + EV: EFS HR 0.51 (95% CI, 0.38–0.67); OS HR 0.58 (95% CI, 0.40–0.83) ➡️ D + T + EV: EFS HR 0.61 (95% CI, 0.47–0.80); OS did not meet statistical significance ➡️ Pathological complete response (pCR): 45% with D + EV vs 10% with control ➡️ Grade 3/4 treatment-related adverse events (TRAEs): 30% with D + EV vs 42% with control ✅ Both primary EFS endpoints were met. Perioperative durvalumab plus 3 cycles of neoadjuvant EV also significantly improved OS. 🎙️ Presenter: Thomas Powles 👥 Investigators: Alexandra Drakaki · Jeremy Teoh · Enrique Grande · Mario Fontes-Sousa · Camillo Porta · Esther Wu · Erik Goluboff · Svetlana Ho · Stephan Hois · Ashok Gupta · James Catto @DrChoueiri @tompowles1 @apolo_andrea @neerajaiims @montypal @Silke_Gillessen @AOmlin @brian_rini @PGrivasMDPhD @TiansterZhang @amerseburger @DrDanielHeng @HHammersMD @scocmem @AndreaNecchi @AmandaNizamMD @drenriquegrande @nataliagandur @AlbigesL @cdanicas @declangmurphy @seanmmcbride @shilpaonc @DrRanaMcKay @scserendipity1 @DrYukselUrun @ravikanesvaran @BraunMDPhD @EfstathiouEleni @mzugman @crisbergerot @niklas_kluemper @Markuseckstein3

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OncoAlert · Oct 28, 2026 · 10:30 AM UTC

Axel S. Merseburger retweeted

@OncoAlertOct 28

Thank you Colleagues for a phenomenal #ESMO26 ESMO in Madrid is a wrap, and we are grateful to everyone who shared, discussed, debated and amplified the science this week. You turned five days in Madrid into a truly global conversation. 🌍 OUR Network's MISSION: Keep our colleagues worldwide Up To date in REAL TIME. 📣 101.7M impressions of potential reach 💬 6.1K posts on X from 988 participants in 34 countries ⚡ 43.1 posts per hour across the meeting days 😊 45% positive sentiment, with only 6% negative Real-time metrics powered by ACUVOX. WWW.ACUVOX.IO 🏆 Top influencers @DrChoueiri, @StephenVLiu, @PTarantinoMD, @dr_yakupergun, @HHorinouchi, @zklaassen_md, @stolaney1, @ArndtVogel, @DrYukselUrun, @DraMartinezLago, @tompowles1, @SuyogCancer, @adamfeuerstein, @ScaltritiLab, @GIMedOnc, @ScottGottliebMD, @barriere_dr, @_ShankarSiva, @miriamgonp, @TiansterZhang, @matteolambe, @NiuSanford, @christine_lovly, @amerseburger, @GlopesMd, @montypal, @Icro_Meattini, @PGrivasMDPhD, @brian_rini, @CathyEngMD, @apolo_andrea, @AndreaNecchi, @DrSGraff, @graokane, @to_be_elizabeth, @ElisaAgostinett, @nataliagandur, @UOzkerim, @DrMirallas, @Lucarecco, @mzugman, @p_ciracimd, @DrVilmaPBarcia, @MarioBalsaMD, @scocmem, @GaiaGriguolo, @JankovicK, @Dr_Oncologista 🌎 Where the conversation came from North America led with 1,940 posts, followed closely by Europe with 1,777. Boston, Madrid and New York were the most active cities. 🔬 Top studies by impact 1️⃣ DeLLphi-305 (SCLC): 4.0M reach, 170 posts 2️⃣ VOLGA (bladder): 3.7M reach, 141 posts 3️⃣ KRASCENDO-1 (NSCLC): 3.5M reach 4️⃣ SAFFRON (NSCLC): 3.3M reach 5️⃣ INTerpath-001 (melanoma): 154 posts Pinging our Collaborators

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OncoAlert · Oct 26, 2026 · 6:30 PM UTC

Axel S. Merseburger retweeted

Neeraj Agarwal, MD, FASCO

🚨 FDA NEWS | By colleagues, for colleagues Talazoparib + enzalutamide now approved for mAPMN/S prostate cancer with HRR gene mutations.TALAPRO-3 delivered a clear rPFS benefit (HR 0.48). Full details & Key Facts graphic below.#OncoAlert #ProstateCancer #FDA fda.gov/drugs/resources-info… Pinging Our Faculty @DrChoueiri, @tompowles1, @apolo_andrea, @neerajaiims, @montypal, @Silke_Gillessen, @AOmlin, @brian_rini, @PGrivasMDPhD, @TiansterZhang, @amerseburger, @DrDanielHeng, @HHammersMD, @scocmem, @AndreaNecchi, @AmandaNizamMD, @drenriquegrande, @nataliagandur, @AlbigesL, @cdanicas, @declangmurphy, @seanmmcbride, @shilpaonc, @DrRanaMcKay, @scserendipity1, @DrYukselUrun, @ravikanesvaran, @BraunMDPhD, @EfstathiouEleni, @mzugman, @crisbergerot, @niklas_kluemper @Markuseckstein3

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Neeraj Agarwal, MD, FASCO · Oct 26, 2026 · 6:15 PM UTC

Axel S. Merseburger retweeted

@neerajaiimsOct 26

Just happened today👏🎉👉 @FDA approved Talazoparib + enzalutamide for pts with HRRm positive mAPMS/mHSPC #prostatecancer FDA Link👉 l1nq.com/ltlq6jk 👉 @NEJM paper tinyurl.com/vkvra8cd 👇 @ASCO @oncoalert @urotoday @PCF_Science @DanaFarber_GU

Image from Neeraj Agarwal, MD, FASCO (@neerajaiims)

Neeraj Agarwal, MD, FASCO

@neerajaiimsMay 30

Breaking news #ASCO26 Adding Talazoparib to enzalutamide significantly ⬆️ rPFS 👉 HR 0.48 in pts w/ mCSPC (mAPMS) #prostatecancer w/ HRRm 👉 @NEJM paper tinyurl.com/vkvra8cd 👇 @ASCO @oncoalert @urotoday @PCF_Science @OpenMedicineHQ

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FDA Drugs and Biologics · Oct 26, 2026 · 5:01 PM UTC

Axel S. Merseburger retweeted

FDA Drugs and Biologics

@FDADrugsOct 26

NEWS: Today, FDA approved a new treatment for metastatic androgen pathway modulation-naïve or -sensitive prostate cancer. fda.gov/drugs/resources-info…

Image from FDA Drugs and Biologics (@FDADrugs)

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OncoAlert · Oct 26, 2026 · 5:48 PM UTC

Axel S. Merseburger retweeted

Dear colleagues, We are already curating THE COMPLETE #ESMO26 NEWSLETTER 📰 our picks of the top trials presented in Madrid, together in one email. Register to receive it 👉 buff.ly/N5gYtAc Every newsletter is curated by oncologists, for colleagues working in cancer care. It’s our way of making science quick and accessible. We are OncoAlert🚨 For Colleagues, by Colleagues Best, The Network @cdanicas @hoperugo @DrChoueiri @TiansterZhang @matteolambe @NiuSanford @stolaney1 @christine_lovly @amerseburger @GlopesMd @tompowles1 @montypal @Icro_Meattini @PGrivasMDPhD @brian_rini @CathyEngMD @apolo_andrea @AndreaNecchi @DrSGraff @BenWestphalen @graokane @to_be_elizabeth @ElisaAgostinett @nataliagandur @UOzkerim @DrMirallas @DrYukselUrun @Lucarecco @mzugman @HHorinouchi @p_ciracimd @DraMartinezLago @DrVilmaPBarcia @GIMedOnc @MarioBalsaMD @scocmem @AmandaNizamMD @GaiaGriguolo @JankovicK @Dr_Oncologista @Erman_Akkus @WeOncologists @niklas_kluemper @Markuseckstein3

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OncoAlert · Oct 26, 2026 · 6:43 AM UTC

Axel S. Merseburger retweeted

The #OncoAlertTOPTweet Day 3 #ESMO26 Post by @OncoAlert 🚨 LITESPARK 012 Adding belzutifan or quavonlimab to pembrolizumab plus lenvatinib does not improve outcomes and increases treatment discontinuation, supporting pembrolizumab plus lenvatinib as a first-line standard of care in advanced ccRCC. #KidneyCancer Pinging Our Faculty @DrChoueiri, @tompowles1, @apolo_andrea, @neerajaiims, @montypal, @Silke_Gillessen, @AOmlin, @brian_rini, @PGrivasMDPhD, @TiansterZhang, @amerseburger, @DrDanielHeng, @HHammersMD, @scocmem, @AndreaNecchi, @AmandaNizamMD, @drenriquegrande, @nataliagandur, @AlbigesL, @cdanicas, @declangmurphy, @seanmmcbride, @shilpaonc, @DrRanaMcKay, @scserendipity1, @DrYukselUrun, @ravikanesvaran, @BraunMDPhD, @EfstathiouEleni, @mzugman, @crisbergerot, @niklas_kluemper @Markuseckstein3

@OncoAlertOct 25

🚨 #ESMO26 #Podium2Screen: LITESPARK-012 in advanced #RCC Our @OncoAlert founding faculty @DrChoueiri presents ➡️ Adding belzutifan or CTLA-4 blockade (quavonlimab) to pembrolizumab + lenvatinib did NOT improve PFS, OS or ORR (n=1688) @tompowles1 @MVossMD @ERPlimackMD @HowardGurney @brian_rini ➡️ Higher discontinuation rates in the triplet arms Pembro + lenvatinib remains a 1L standard 👇 #KidneyCancer Pinging Our Faculty @DrChoueiri, @tompowles1, @apolo_andrea, @neerajaiims, @montypal, @Silke_Gillessen, @AOmlin, @brian_rini, @PGrivasMDPhD, @TiansterZhang, @amerseburger, @DrDanielHeng, @HHammersMD, @scocmem, @AndreaNecchi, @AmandaNizamMD, @drenriquegrande, @nataliagandur, @AlbigesL, @cdanicas, @declangmurphy, @seanmmcbride, @shilpaonc, @DrRanaMcKay, @scserendipity1, @DrYukselUrun, @ravikanesvaran, @BraunMDPhD, @EfstathiouEleni, @mzugman, @crisbergerot, @niklas_kluemper @Markuseckstein3

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OncoAlert · Oct 26, 2026 · 6:40 AM UTC

Axel S. Merseburger retweeted

The #OncoAlertTOPTweet Day 3 #ESMO26 Post @OncoAlert Presenter @montypal 🇺🇸 of @cityofhope XmAb819 XmAb819 demonstrates promising antitumor activity in heavily pretreated ccRCC, supporting further development despite substantial treatment-related toxicity. #KidneyCancer Pinging Our Faculty @DrChoueiri, @tompowles1, @apolo_andrea, @neerajaiims, @montypal, @Silke_Gillessen, @AOmlin, @brian_rini, @PGrivasMDPhD, @TiansterZhang, @amerseburger, @DrDanielHeng, @HHammersMD, @scocmem, @AndreaNecchi, @AmandaNizamMD, @drenriquegrande, @nataliagandur, @AlbigesL, @cdanicas, @declangmurphy, @seanmmcbride, @shilpaonc, @DrRanaMcKay, @scserendipity1, @DrYukselUrun, @ravikanesvaran, @BraunMDPhD, @EfstathiouEleni, @mzugman, @crisbergerot, @niklas_kluemper @Markuseckstein3

@OncoAlertOct 25

OncoAlert #Podium2Screen🚨 #ESMO26 XmAb819 in #RCC Our @OncoAlert founding faculty @montypal 🇺🇸presents a first-in-class ENPP3 x CD3 bispecific in heavily pretreated ccRCC: ➡️ ORR 27%, DCR 68% ➡️ Activity after prior HIF-2α inhibitor (ORR 26%) ➡️ 15/16 responders still on treatment #KidneyCancer @AlbigesL, @MehmetAsimBilen Pinging Our Faculty @DrChoueiri, @tompowles1, @apolo_andrea, @neerajaiims, @montypal, @Silke_Gillessen, @AOmlin, @brian_rini, @PGrivasMDPhD, @TiansterZhang, @amerseburger, @DrDanielHeng, @HHammersMD, @scocmem, @AndreaNecchi, @AmandaNizamMD, @drenriquegrande, @nataliagandur, @AlbigesL, @cdanicas, @declangmurphy, @seanmmcbride, @shilpaonc, @DrRanaMcKay, @scserendipity1, @DrYukselUrun, @ravikanesvaran, @BraunMDPhD, @EfstathiouEleni, @mzugman, @crisbergerot, @niklas_kluemper @Markuseckstein3

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OncoAlert · Oct 26, 2026 · 6:41 AM UTC

Axel S. Merseburger retweeted

The #OncoAlertTOPTweet Day 3 #ESMO26 Post @OncoAlert 🚨 Presenter @DrDanielHeng 🇨🇦 LITESPARK 11 Belzutifan plus lenvatinib improves disease control and response durability versus cabozantinib after anti–PD-(L)1 therapy in advanced clear-cell renal-cell carcinoma, without a statistically significant overall survival benefit. #kidneycancer Pinging Our Faculty @DrChoueiri, @tompowles1, @apolo_andrea, @neerajaiims, @montypal, @Silke_Gillessen, @AOmlin, @brian_rini, @PGrivasMDPhD, @TiansterZhang, @amerseburger, @DrDanielHeng, @HHammersMD, @scocmem, @AndreaNecchi, @AmandaNizamMD, @drenriquegrande, @nataliagandur, @AlbigesL, @cdanicas, @declangmurphy, @seanmmcbride, @shilpaonc, @DrRanaMcKay, @scserendipity1, @DrYukselUrun, @ravikanesvaran, @BraunMDPhD, @EfstathiouEleni, @mzugman, @crisbergerot, @niklas_kluemper @Markuseckstein3

@OncoAlertOct 25

OncoAlert 🚨 #ESMO26 #Podium2Screen LITESPARK-011 final analysis in #RCC Our @OncoAlert founding faculty @DanielHengMD 🇨🇦 presents belzutifan + lenvatinib vs cabo after anti–PD-(L)1: ➡️ PFS HR 0.74 (14.8 vs 10.8 mo) ➡️ ORR 53% vs 40%, DOR 22.0 vs 11.9 mo ➡️ OS HR 0.85, not significant 👇 #KidneyCancer #GUOnc Pinging Our Faculty @DrChoueiri, @tompowles1, @apolo_andrea, @neerajaiims, @montypal, @Silke_Gillessen, @AOmlin, @brian_rini, @PGrivasMDPhD, @TiansterZhang, @amerseburger, @DrDanielHeng, @HHammersMD, @scocmem, @AndreaNecchi, @AmandaNizamMD, @drenriquegrande, @nataliagandur, @AlbigesL, @cdanicas, @declangmurphy, @seanmmcbride, @shilpaonc, @DrRanaMcKay, @scserendipity1, @DrYukselUrun, @ravikanesvaran, @BraunMDPhD, @EfstathiouEleni, @mzugman, @crisbergerot, @niklas_kluemper @Markuseckstein3

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Niklas Klümper · Oct 25, 2026 · 6:17 PM UTC

Axel S. Merseburger retweeted

@niklas_kluemperOct 25

Honoured to have had the opportunity to present "Optimal induction treatment in non-metastatic bladder cancer" at #ESMO26 in Madrid! 🚨 Does a deeper pathological response translate into greater survival benefit in perioperative MIBC? An intriguing pattern across four phase III trials: 🔹 NIAGARA: ΔpCR +10 pp | EFS HR 0.68 🔹 KEYNOTE-B15: +23 pp | HR 0.53 🔹 VOLGA: +32 pp | HR 0.51 🔹 KEYNOTE-905: +49 pp | HR 0.40 Larger absolute pCR gains appear to track with greater EFS benefit. But the comparator matters! KEYNOTE-905 and VOLGA used surgery-based controls without neoadjuvant systemic therapy (control "pCR" ~8–9%), whereas NIAGARA and KEYNOTE-B15 used active neoadjuvant cisplatin-based chemotherapy. Thus, the magnitude of ΔpCR is not directly comparable across trials. The key question: Can pCR, combined with utDNA + ctDNA clearance, become a reliable tool for response-adapted treatment intensity? ⚠️ This is an exploratory, trial-level observation—not proof that pCR improvements cause EFS benefits or that pCR is a validated surrogate endpoint! Better biomarkers could help us maximize cure while minimizing overtreatment. 🔬 #ESMO26 #BladderCancer @weoncologists @urotoday @Uromigos @OncoAlert Faculty: @DrChoueiri @tompowles1 @apolo_andrea @neerajaiims @montypal @Silke_Gillessen @AOmlin @brian_rini @PGrivasMDPhD @TiansterZhang @amerseburger @DrDanielHeng @HHammersMD @scocmem @AndreaNecchi @AmandaNizamMD @drenriquegrande @nataliagandur @AlbigesL @cdanicas @declangmurphy @seanmmcbride @shilpaonc @DrRanaMcKay @scserendipity1 @DrYukselUrun @ravikanesvaran @BraunMDPhD @EfstathiouEleni @mzugman @crisbergerot @Markuseckstein3

Image from Niklas Klümper (@niklas_kluemper)

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OncoAlert · Oct 24, 2026 · 12:45 PM UTC

Axel S. Merseburger retweeted

@OncoAlertOct 24

OncoAlert 4Sight Abstracts to be Presented at #ESMO26 Perioperative Durvalumab With or Without Tremelimumab Plus Neoadjuvant Enfortumab Vedotin in Muscle-Invasive Bladder Cancer: Results From the Phase 3 VOLGA Trial @tompowles1 @jteoh_hk @CPRT65 🔬 Phase 3 (n=695): perioperative durvalumab ± tremelimumab + neoadjuvant enfortumab vedotin vs control (RC, then observation or approved adjuvant therapy) in cisplatin-ineligible MIBC. Interim analysis; median EFS follow-up 22.9 mo. ➡️ D+EV: EFS HR 0.51 (0.38–0.67); OS HR 0.58 (0.40–0.83) ➡️ D+T+EV: EFS HR 0.61 (0.47–0.80); OS did not meet significance ➡️ pCR 45% (D+EV) vs 10% (control); grade 3/4 TRAEs 30% and 42% ✅ Both EFS primary endpoints met; perioperative durvalumab plus 3 cycles of neoadjuvant EV also significantly improved OS. 🎙️ Thomas Powles 👥 Alexandra Drakaki · Jeremy Teoh · Enrique Grande · Mario Fontes-Sousa · Camillo Porta · Esther Wu · Erik Goluboff · Svetlana Ho · Stephan Hois · Ashok Gupta · James Catto (4Sight Made from Abstracts publicly available at the ESMO website) @DrChoueiri, @tompowles1, @apolo_andrea, @neerajaiims, @montypal, @Silke_Gillessen, @AOmlin, @brian_rini, @PGrivasMDPhD, @TiansterZhang, @amerseburger, @DrDanielHeng, @HHammersMD, @scocmem, @AndreaNecchi, @AmandaNizamMD, @drenriquegrande, @nataliagandur, @AlbigesL, @cdanicas, @declangmurphy, @seanmmcbride, @shilpaonc, @DrRanaMcKay, @scserendipity1, @DrYukselUrun, @ravikanesvaran, @BraunMDPhD, @EfstathiouEleni, @mzugman, @crisbergerot, @niklas_kluemper @Markuseckstein3

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OncoAlert · Oct 24, 2026 · 1:45 PM UTC

Axel S. Merseburger retweeted

@OncoAlertOct 24

OncoAlert 4Sight Abstracts to be Presented at #ESMO26 Darolutamide With Androgen Deprivation Therapy (ADT) and Definitive or Salvage Locoregional Radiation Therapy (RT) for Localised, Very High-Risk Prostate Cancer: Interim Analysis of an International, Placebo-Controlled, Randomised Phase 3 Trial (DASL-HiCaP; ANZUP1801) @niazi_Dr7 @seanmmcbride @DocJarad @RayMcDermott1 🔬 Phase 3 (n=1106): darolutamide vs placebo added to 96 weeks of ADT plus prostate/pelvic RT in very high-risk localized or post-prostatectomy persistent/recurrent prostate cancer. Interim analysis; median follow-up 3.8 years. ➡️ 4-yr MFS 95% vs 88%; HR 0.42 (0.27–0.66); p=0.0001 ➡️ PSA-PFS HR 0.47 (0.33–0.67); OS HR 0.88 (0.49–1.59) ➡️ Grade ≥3 AEs 43% vs 36% ✅ Darolutamide significantly improved MFS-CI; follow-up is ongoing to confirm MFS-CI surrogacy for OS. #ProstateCancer 🎙️ Tamim Niazi 👥 Sean McBride · Scott Williams · Ian Davis · Martin Stockler · Andrew Martin · Karen Bracken · Felicia Roncolato · Lisa Horvath · Shomik Sengupta · Jarad Martin · Tee Lim · Simon Hughes · Raymond McDermott · James Catto · Paul Kelly · Wendy Parulekar · Scott Morgan · Ricardo Rendon · Christopher Sweeney (4Sight Made from Abstracts publicly available at the ESMO website) Pinging Our Faculty @DrChoueiri, @tompowles1, @apolo_andrea, @neerajaiims, @montypal, @Silke_Gillessen, @AOmlin, @brian_rini, @PGrivasMDPhD, @TiansterZhang, @amerseburger, @DrDanielHeng, @HHammersMD, @scocmem, @AndreaNecchi, @AmandaNizamMD, @drenriquegrande, @nataliagandur, @AlbigesL, @cdanicas, @declangmurphy, @seanmmcbride, @shilpaonc, @DrRanaMcKay, @scserendipity1, @DrYukselUrun, @ravikanesvaran, @BraunMDPhD, @EfstathiouEleni, @mzugman, @crisbergerot, @niklas_kluemper @Markuseckstein3

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OncoAlert · Oct 24, 2026 · 5:15 AM UTC

Axel S. Merseburger retweeted

Axel S. Merseburger@amerseburgerOct 23

@OncoAlertOct 24

OncoAlert 4Sight Abstracts to be Presented at #ESMO26 Results From a Phase 3 Trial of Neoadjuvant Chemotherapy Alone vs in Combination With Nivolumab Followed by Postsurgical Adjuvant Nivolumab in Patients With Muscle-Invasive Bladder Cancer (MIBC) 🔬 Phase 3 (n=653): neoadjuvant nivolumab + gemcitabine/cisplatin then adjuvant nivolumab vs neoadjuvant GC in MIBC. Primary endpoints: EFS and pCR. ➡️ EFS HR 0.94 (95.74% CI 0.71–1.25); P=0.67 ➡️ pCR 39.1% vs 29.6%; OR 1.54 (99.91% CI 0.88–2.69) ➡️ OS immature: HR 0.88 (0.64–1.21); grade ≥3 TRAEs 45.9% vs 49.5% ✅ No statistically significant differences in EFS or pCR; safety of nivolumab + GC consistent with the individual agents. 🎙️ Andrea Necchi (4Sight Made from Abstracts publicly available at the ESMO website) Pinging Our Faculty @DrChoueiri, @tompowles1, @apolo_andrea, @neerajaiims, @montypal, @Silke_Gillessen, @AOmlin, @brian_rini, @PGrivasMDPhD, @TiansterZhang, @amerseburger, @DrDanielHeng, @HHammersMD, @scocmem, @AndreaNecchi, @AmandaNizamMD, @drenriquegrande, @nataliagandur, @AlbigesL, @cdanicas, @declangmurphy, @seanmmcbride, @shilpaonc, @DrRanaMcKay, @scserendipity1, @DrYukselUrun, @ravikanesvaran, @BraunMDPhD, @EfstathiouEleni, @mzugman, @crisbergerot, @niklas_kluemper @Markuseckstein3

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Axel S. Merseburger · Oct 23, 2026 · 5:31 PM UTC

Happy to see some posters with good visuals and less text 📚I can remember and understand in 5 minutes poster walk 🚶 at @myESMO #ESMO26 Take home: BRAC-1/2 not more prevalent in young men @OncoAlert

Image from Axel S. Merseburger (@amerseburger)

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Dra. María Natalia Gandur Quiroga · Oct 23, 2026 · 12:40 PM UTC

Axel S. Merseburger retweeted

Dra. María Natalia Gandur Quiroga

@nataliagandurOct 23

🚨⭐🟠 #ESMO26 | Abstract 4733O | KEYNOTE-905 / EV-303 Perioperative Pembrolizumab or Enfortumab Vedotin + Pembrolizumab in Cisplatin-Ineligible Muscle-Invasive Bladder Cancer: Ad Hoc Analysis 🎤 Presented by Anders Ullén 🇸🇪 @OncoAlert 🔬 What is the contribution of each agent to the benefit of perioperative EV + pembrolizumab? 📊 STUDY DESIGN Exploratory 3-arm analysis | N=255 Patients with #MIBC ineligible for or declining cisplatin, concurrently randomized to: 🟢 EV + pembrolizumab (n=85) 🔵 Pembrolizumab alone (n=83) 🔴 Radical cystectomy + PLND alone (n=87) 📊 KEY RESULTS ✅ OVERALL SURVIVAL 🔹 EV + pembro vs control: HR 0.48 (95% CI 0.29–0.80) 🔹 Pembro vs control: HR 0.76 (95% CI 0.48–1.20) 📈 Median OS: • EV + pembro: NR • Pembro: 51.0 months • Control: 41.7 months ✅ PATHOLOGICAL COMPLETE RESPONSE 🟢 EV + pembro: 58.8% 🔵 Pembro: 25.3% 🔴 Control: 10.3% Absolute differences vs control: • EV + pembro: +48.6 percentage points • Pembro: +15.7 percentage points 📌 EFS and OS favored perioperative EV + pembro versus surgery alone, while pembrolizumab monotherapy showed numerically favorable outcomes. ⚠️ SAFETY Grade ≥3 AEs: • Neoadjuvant: 44.0% vs 20.7% (EV + pembro vs pembro) • Adjuvant: 60.0% vs 44.9% 🔬 INTERPRETATION The efficacy pattern supports a potential contribution of both EV and pembrolizumab. However, this was an ad hoc exploratory analysis, and comparisons should not be interpreted as confirmatory evidence of the independent contribution of each drug. ⭐ MY POINT OF VIEW | CLINICAL PEARL The question is evolving from whether perioperative EV + pembrolizumab works to understanding why the combination works—and which patients truly need both agents. The striking pCR difference and favorable OS signal reinforce the biological rationale for combining an ADC with immune checkpoint inhibition. 💡 But treatment intensification must always be balanced against toxicity, patient fitness and long-term benefit. 📌 EV + pembrolizumab is an established perioperative option for cisplatin-ineligible MIBC based on the parent KEYNOTE-905 trial. These exploratory findings add insight rather than establish a new treatment indication. 🌍 GU Oncology Community @gbanna74 @ravikanesvaran @urologysummit @tompowles1 @brian_rini @montypal @crisbergerot @DrDanielHeng @apolo_andrea @DrChoueiri @PGrivasMDPhD @TiansterZhang @HHammersMD @neerajaiims @amerseburger @sonpavde @drenriquegrande @scserendipity1 @Silke_Gillessen @EfstathiouEleni @BraunMDPhD @cdanicas @AOmlin @declangmurphy @salvolarosa @RenuEapen @seanmcbride @DrJaVallejo @ecancer @UrologyTimes @urotoday @wearemedsir @OpenMedicineHQ @UCSFCancer #BladderCancer #MIBC #GUOncology #ADC #ClinicalTrials

Image from Dra. María Natalia Gandur Quiroga (@nataliagandur)

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OncoAlert · Oct 23, 2026 · 12:22 PM UTC

Axel S. Merseburger retweeted

@OncoAlertOct 23

🇪🇸 #ESMO26 Day 1 in numbers 📊 and it Just got Started 🔥 17.9M impressions 💬 1.1K posts 👥 437 participants 🌍 26 countries ⚡ 18.7 posts/hour Proud to lead the conversation at #1 💪 Thank you @myESMO and everyone sharing the science from Madrid 🙌 Real-time metrics powered by AcuVox 🎙️ AcuVox.io @cdanicas @hoperugo @DrChoueiri @TiansterZhang @matteolambe @NiuSanford @stolaney1 @christine_lovly @amerseburger @GlopesMd @tompowles1 @montypal @Icro_Meattini @PGrivasMDPhD @brian_rini @CathyEngMD @apolo_andrea @AndreaNecchi @DrSGraff @BenWestphalen @graokane @to_be_elizabeth @ElisaAgostinett @nataliagandur @UOzkerim @DrMirallas @DrYukselUrun @Lucarecco @mzugman @HHorinouchi @p_ciracimd @DraMartinezLago @DrVilmaPBarcia @GIMedOnc @MarioBalsaMD @scocmem @AmandaNizamMD @GaiaGriguolo @JankovicK @Dr_Oncologista @Erman_Akkus @WeOncologists @niklas_kluemper @Markuseckstein3 @PTarantinoMD @ScottGottliebMD @VivekSubbiah @dr_yakupergun

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Niklas Klümper · Oct 23, 2026 · 6:04 AM UTC

Axel S. Merseburger retweeted

@niklas_kluemperOct 23

🚨 Important biomarker signal from #ESMO2026—highly relevant beyond breast cancer! In the neoadjuvant TALENT trial T-DXd achieved relatively low pCR/near-pCR rates (16–17%) in HER2-low breast cancer. Importantly, higher baseline HER2 expression was associated with better pathological response, while HER2 expression declined substantially during treatment. Could the same principle apply to perioperative enfortumab vedotin + pembrolizumab in MIBC? We urgently need to understand whether low or absent membranous NECTIN4 expression identifies patients less likely to achieve pCR—and potentially at higher risk of recurrence despite EV+pembro. Histology, quantitative membranous NECTIN4 expression, spatial heterogeneity and ctDNA dynamics should be integrated into prospective biomarker studies. @Markuseckstein3 @DrRosenbergMSK @Dr_Aggen Precision perioperative therapy must start before cycle 1—not only after cystectomy. 🔬 @OncoAlert Faculty @DrChoueiri , @tompowles1 , @apolo_andrea , @neerajaiims , @montypal , @Silke_Gillessen , @AOmlin , @brian_rini , @PGrivasMDPhD , @TiansterZhang , @amerseburger , @DrDanielHeng , @HHammersMD , @scocmem , @AndreaNecchi , @AmandaNizamMD , @drenriquegrande , @nataliagandur , @AlbigesL , @cdanicas , @declangmurphy , @seanmmcbride , @shilpaonc , @DrRanaMcKay , @scserendipity1 , @DrYukselUrun , @ravikanesvaran , @BraunMDPhD , @EfstathiouEleni , @mzugman , @crisbergerot

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Niklas Klümper · Oct 23, 2026 · 9:21 AM UTC

Axel S. Merseburger retweeted

Axel S. Merseburger@amerseburgerOct 23

@niklas_kluemperOct 23

🚨 Important new ctDNA data from KEYNOTE-B15 at ESMO 2026! In cisplatin-eligible MIBC, EV+pembrolizumab achieved: 🔹 82.1% ctDNA clearance during neoadjuvant treatment vs 66.7% with gemcitabine/cisplatin. 🔹 87.0% ctDNA negativity before surgery vs 80.3% with chemotherapy. 🔹 95.2% ctDNA negativity after cystectomy vs 86.5% with chemotherapy. Strikingly, only 4.8% remained ctDNA-positive after neoadjuvant EV+pembrolizumab and surgery! We know from IMvigor011 that postoperative ctDNA can identify patients at high risk of recurrence and help guide adjuvant treatment strategies. But what about patients achieving both pCR and sustained ctDNA negativity? Do they really need another 5–6 cycles of adjuvant EV, with the potential for cumulative tox/ neuropathy? Could pCR + ctDNA clearance, followed by longitudinal ctDNA monitoring, define a population suitable for treatment de-escalation? VOLGA will add another important piece to this puzzle, using only 3 neoadjuvant EV cycles without adjuvant EV. Of course, neither KEYNOTE-B15 nor VOLGA can establish the necessity of adjuvant EV through cross-trial comparisons. We urgently need prospective, biomarker-guided de-escalation trials—not simply more treatment for everyone. @OncoAlert Faculty @DrChoueiri , @tompowles1 , @apolo_andrea , @neerajaiims , @montypal , @Silke_Gillessen , @AOmlin , @brian_rini , @PGrivasMDPhD , @TiansterZhang , @amerseburger , @DrDanielHeng , @HHammersMD , @scocmem , @AndreaNecchi , @AmandaNizamMD , @drenriquegrande , @nataliagandur , @AlbigesL , @cdanicas , @declangmurphy , @seanmmcbride , @shilpaonc , @DrRanaMcKay , @scserendipity1 , @DrYukselUrun , @ravikanesvaran , @BraunMDPhD , @EfstathiouEleni , @mzugman , @crisbergerot @Markuseckstein3

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Axel S. Merseburger · Oct 23, 2026 · 11:49 AM UTC

KEYNOTE-866 did not show EFS not OS. Great presentation 👏🏼by Prof Jens Bedke #ESMO26 @OncoAlert @Uromigos @urotoday @Uroweb @DGUrologie @high5md

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Niklas Klümper · Oct 23, 2026 · 11:25 AM UTC

Axel S. Merseburger retweeted