Top 5 Papers
#1
Source: JAMA Oncology | Authors: Reiss KA, Xia M, Akamandisa M, et al. (Penn / Abramson Cancer Center) | Published: April 30, 2026
Score: 12/20 — Base: JAMA Oncology (7) + Phase II maintenance trial (+2) + Biomarker-guided/precision (+1) + Survival benefit signal (+2) = 12
Long-term follow-up of the investigator-initiated phase II trial of maintenance rucaparib in platinum-sensitive advanced pancreatic cancer with germline or somatic BRCA1, BRCA2 or PALB2 pathogenic variants (n=42 evaluable: 27 germline BRCA2, 7 germline BRCA1, 6 germline PALB2, 2 somatic BRCA2). Reiss and colleagues report a 6-month PFS rate of 59.5%, median PFS 13.1 months, and median OS 23.5 months. Among 36 patients with measurable disease, ORR was 41.7% (3 CRs, 12 PRs). Crucially, with extended follow-up 7 of 42 patients remained progression-free for over 4 years, including patients who discontinued rucaparib for AEs years earlier without progression — supporting durable, biology-driven benefit in HR-deficient PDAC and reinforcing the case for genomic profiling at diagnosis.
Post angle: Maintenance PARP inhibition is a real long-term strategy in HR-deficient PDAC. Test germline + somatic BRCA1/2 and PALB2 in every metastatic pancreatic case. #PDAC #PARP #PrecisionOncology #GIOnc
#2
Source: FDA / Revolution Medicines (Press Release) | Authors: Revolution Medicines, Inc. | Published: May 1, 2026
Score: 10/20 — Base: FDA regulatory action (8) + Survival benefit underpinning the EAP (PANOVA-3-adjacent / RASolute 302 OS HR 0.40) (+2) = 10
On May 1, 2026, the FDA issued a 'safe to proceed' letter to Revolution Medicines authorizing initiation of an Expanded Access Program (EAP) for daraxonrasib (RMC-6236), an investigational oral RAS(ON) multi-selective inhibitor, in adults with previously treated metastatic pancreatic ductal adenocarcinoma. The EAP is grounded in the prior pivotal phase 3 RASolute 302 readout (median OS 13.2 vs 6.7 months vs SoC chemo, HR 0.40, p<0.0001 — to be presented at the 2026 ASCO Plenary on May 31). Per FDA EAP regulations, requests must be initiated by a licensed treating physician (not patients/caregivers); Revolution Medicines is opening sites as quickly as possible and asks physicians to contact medinfo@revmed.com. This is a meaningful pre-approval pathway for KRAS-mutant 2L+ PDAC patients with no satisfactory alternative — and a bridge until full FDA approval following the Plenary data.
Post angle: If you have a 2L+ KRAS-mutant metastatic PDAC patient who is out of standard options, the daraxonrasib EAP is now real. Physicians initiate via medinfo@revmed.com. #PDAC #KRAS #ExpandedAccess #GIOnc
#3
Source: Journal of Clinical Oncology | Authors: Sharma MR, Powderly J, Kuboki Y, Strickler JH, et al. | Published: May 1, 2026
Score: 10/20 — Base: JCO (8) + Phase I (~+1) + Biomarker-driven (c-Met) novel ADC payload (+1) = 10
First-in-human phase I of telisotuzumab adizutecan (Temab-A / ABBV-400), a c-Met-targeting antibody conjugated to a novel topoisomerase-1 inhibitor payload, in 122 patients with KRAS wild-type, MSS/pMMR metastatic colorectal cancer. The 3.0 mg/kg q3w dose was the MTD; across all doses the overall response rate was 15.6% (95% CI 9.6-23.2), disease control rate 74.6%, median duration of response 5.9 months, median PFS 4.6 months, and median OS 10.4 months — with higher activity at 2.4 and 3.0 mg/kg. AEs were predominantly GI (78%) and hematologic (71%), with treatment-related discontinuations 10% and treatment-related deaths 3%. Selected dose 2.4 mg/kg q3w for further development. A meaningful new biomarker-defined option in heavily pre-treated MSS mCRC.
Post angle: The c-Met ADC space is finally moving in MSS mCRC. 15.6% ORR / 74.6% DCR in late-line is signal worth tracking. Watch for randomized data. #mCRC #ADC #cMET #GIOnc
#4
Source: New England Journal of Medicine | Authors: Fitzgerald RC. (Early Cancer Institute, University of Cambridge) | Published: April 30, 2026
Score: 10/20 — Base: NEJM (10) — Clinical Practice review; NEJM safety-net rule applies
Definitive NEJM Clinical Practice review by Fitzgerald on Barrett's esophagus as the primary precursor to esophageal adenocarcinoma. The article reframes diagnosis (≥1 cm columnar segment with intestinal metaplasia + goblet cells), articulates a risk-stratified surveillance strategy aimed at catching high-grade dysplasia and intramucosal cancer at a stage curable by endoscopic resection plus ablation (vs morbid esophagectomy or palliative chemo), and underscores the under-diagnosis problem given Barrett's lacks specific symptoms beyond reflux. Importantly for medical oncology referral patterns, she emphasises participation in trials testing detection biomarkers and chemoprevention.
Post angle: If we want to bend the EAC mortality curve, the action is upstream — better Barrett's case-finding, better risk stratification, more endoscopic cures. Required reading for any GI/thoracic onc team. #BarrettsEsophagus #EsophagealCancer #GIOnc
#5
Source: ASCO Educational Book | Authors: Wong EYT, Damle SR, Shiu KK, Cohen SA, Lieu CH | Published: May 1, 2026
Score: 8/20 — Base: ASCO Educational Book / plenary-adjacent (6) + Practice-changing topic synthesis (+2) = 8
ASCO 2026 educational review synthesizing where immunotherapy fits — and doesn't — in localized colorectal cancer. Neoadjuvant single-agent or doublet PD-1 blockade in dMMR/MSI-H colon and rectal cancer continues to deliver near-universal major pathologic responses and rising rates of pathologic and clinical complete responses; in dMMR rectal cancer, organ preservation via 'watch-and-wait' after immunotherapy is emerging as a credible standard for highly selected patients on rigorous surveillance. The authors weigh open questions (regimen, duration, when ctDNA can replace pathology, MSS-specific strategies including IO + chemo/RT/novel modulators) and call for response-adapted, biomarker-driven trial designs.
Post angle: dMMR localized CRC is becoming a non-operative disease for selected patients. The MSS arm of the field is the next frontier — combinations + ctDNA + smarter trial designs. #CRC #Immunotherapy #ctDNA #ASCO26 #GIOnc
Additional Papers of Interest
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Eur J Gastroenterol Hepatol — All AI systems beat standard colonoscopy on ADR; EndoAngel led (OR 1.84, SUCRA 0.9), but no system improved detection of advanced or sessile serrated lesions.
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JCO — Dossa, Yeung, and Garcia-Aguilar parse how to safely select near-cCR patients for organ preservation after total neoadjuvant therapy.
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ASCO Educational Book — Goyal, Chung, Mori et al. on context-aware AI across endoscopy, trial design, and EHR-driven trial-matching pipelines for GI oncology.
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Nature Medicine — Lee, Baca and Ng (Dana-Farber) frame the modifiable-exposure roadmap underlying the rise in early-onset CRC.
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Cardio-Oncology (Emory) — In 270 NET patients, 41% of those with carcinoid syndrome developed CHD; CHD was independently associated with markedly worse survival (HR 7.09).
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J Med Econ — Atezo+bev added 0.873 QALYs vs lenvatinib at ICER ~RM 51,399/QALY (~0.91× Malaysia GDP/capita), supporting public-payer adoption.
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