🌶️🌡️Summary of my uropathology for urologists and oncologists series! 👉check it out! and retweet if you like! @urotoday @OncoAlert @Uroweb @EAUYAUrology @EAU_YAUroTech @EauPatient @niklas_kluemper @onkowissen

🚨 How much adjuvant EV do we really need in MIBC? Same 3 neoadjuvant EV cycles. Two positive phase III trials. One major difference: 🔹 KEYNOTE-905/EV-303: 6 additional EV cycles after cystectomy 🔹 VOLGA: No adjuvant EV Peripheral neuropathy: 37% vs 18%. An absolute difference of 19 percentage points—approximately 1 additional neuropathy event per 6 patients treated. -> NNH 6! But ⚠️ these are cross-trial rates, not a randomized comparison. We cannot attribute the difference solely to adjuvant EV. With curative intent, cumulative neurotoxicity matters. Could pCR + postoperative ctDNA help identify patients who can safely omit adjuvant EV? Maximize cures. Minimize unnecessary toxicity. 🔬 #ESMO26 #BladderCancer @OncoAlert @weoncologists @urotoday @Uromigos @OncoAlert and 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

Biomarker analysis exploring within-patient gene-expression ratios and deterministic single-sample predictions. This is an alternative to the high vs low classic approach @brian_rini #ESMO26

AI allows pre-screening of FGFR3 mutational status using routine histology slides of muscle-invasive bladder cancer. An AI model reading routine H&E slides pre-screened FGFR3 mutations with >93% sensitivity in advanced cases and could cut molecular testing by ~40%. #BladderCancer #AuthorCommentary with @Markuseckstein3 @UniFAU > bit.ly/4zB9Ht6 @NatureComms

Thanks for picking our study up! A pleasure !!! @urotoday @OncoAlert

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

With VOLGA results coming at #ESMO26, a summary of contemporary phase III perioperative trials in muscle-invasive bladder cancer. ⚠️ Different populations and designs—avoid cross-trial comparisons. VOLGA and EV-303 importantly include surgery-alone control arms without neoadjuvant therapy. 🔑 The next challenge: identifying who truly needs adjuvant ADC therapy—and who can safely avoid it. #BladderCancer #GUOnc @OncoAlert @BladderCancerUS

SAC-TMT + pembro shows 68% response rates in metastastic bladder cancer #ESMO2026 . Trofuse-55 explores this combination in bladder sparing approaches in a randomized phase 3. The triplet with EVP seems a justified research randomised question. Triplet data from yesterday showed 81% RRs. @OncoAlert

Really encouraging data. And trop2 is ubiquitous except for NEC and sarcomatoid. Exciting data for challenge!

Thank you for highlighting this study @DrBarbiOnc!

Happy to have presented "Optimal induction treatment in non-metastatic bladder cancer" at #ESMO26 Madrid! Big thanks to the fantastic panel! @MichvdHeijden @giannatempopatr @LAUrology_NL Main message: deeper response = greater benefit. EV-based induction moves pCR most – and VOLGA suggests less EV may be enough! @OncoAlert @weoncologists @urotoday @Uromigos @OncoAlert and 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

What a great honor @niklas_kluemper ! Well deserved and you did a great job. Your dedication about urooncology brought you there and will even bring you far further - carry on my friend it is a pleasure and just fun working with you and trying to shape the UC sphere for the best of our patients!

A MASSIVE THANKS TO THE #ESMO26 PULSE To our Amazing Senior Faculty🚨and our Awesome #OncoAlertAF You are all amazing and proud to be among you!! We Come from different places but at the end WE ARE ALL OncoAlert 🌐 Save travels to all flying today!!

The #OncoAlertTOPTweet Day 3 #ESMO26 Post @OncoAlert Presenter @DrChoueiri 🇺🇸 of @DanaFarber KEYNOTE 564 Adjuvant pembrolizumab provides durable DFS and OS benefits, supporting its use as standard care for patients with ccRCC at increased risk of recurrence after surgery. #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

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

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

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

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

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

An OncoAlert #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

🚨 #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