It's official! 🍾

I have been appointed Editor in Chief of Radiotherapy & Oncology, aka the Green Journal, @ESTRO_RT's first official journal, starting May 2024.

Extremely honored, but also a bit frightened by the task. Big shoes to fill. Will do one step at a time...

Soooo many trials on #NasopharyngealCarcinoma conducted by Jun Ma’s team at Sun Yat Sen Cancer Center. And this is just the deescalation trials…

#FlorenceOncology26

Cc @OncoAlert @imrtlee

Brigette Ma’s conclusion on how and for whom intensification of systemic therapy is needed in non metastatic #NasopharyngealCarcinoma at #FlorenceOncology26

@OncoAlert

✨Classement Newsweek : Gustave Roussy, 1er centre de lutte contre le cancer en Europe, 3ème mondial.

Le classement World’s Best Specialized Hospitals 2027 du magazine Newsweek distingue à nouveau Gustave Roussy comme premier centre de lutte contre le #cancer en France 🇫🇷 et en à l’échelle mondiale.

Cette reconnaissance salue l’excellence des #soins et de la #recherche menés à l’Institut, ainsi que l’engagement quotidien de l’ensemble de ses professionnels.

Lire l'actualité 👉 gustaveroussy.fr/fr/news-classe…

Can we safely put more radiation where the tumor is—and less where it isn't?

How to focal boost in prostate cancer radiotherapy☢️: ESTRO clinical practice consensus recommendations

This @ESTRO_RT recommendation reviews evidence supporting focal dose escalation in erapy. While whole-gland dose escalation can improve📈 biochemical progression-free survival (bPFS), it may increase toxicity. The phase III FLAME trial demonstrated that isotolerated focal boosting of intraprostatic tumors improves bPFS without significantly increasing side effects.

The guideline 📖provides practical, evidence-based recommendations for implementing focal boosting using external beam radiotherapy or brachytherapy in routine clinical practice.

@TylerSbrt
@BarbaraJereczek
@Simon_Spohn
@alison_tree
@PietersBradley
@tobbel_swe

@OncoAlert 🚨 #LPCCC26
@Silke_Gillessen
@AOmlin
@ProfKHerrmann
@weoncologists

👉Link to Article in First Comment

Is the PROTEUS trial practice-changing? Or should we be more cautious?

For the first time, a phase III trial demonstrated that perioperative treatment with apalutamide plus androgen deprivation therapy improves pathological response and metastasis-free survival in men with high-risk localized prostate cancer undergoing radical prostatectomy.

Some key reflections:

🔹 A landmark study. PROTEUS provides proof of concept that intensified perioperative systemic therapy can modify the biology of localized prostate cancer and potentially reshape future treatment paradigms.

🔹 A modest absolute benefit. While statistically significant, the absolute improvement in 5-year metastasis-free survival was relatively small. This highlights the need to carefully balance efficacy against toxicity, cost, and the risk of overtreatment.

🔹 An innovative but challenging endpoint. PROTEUS is the first randomized phase III trial to include PSMA-PET-detected metastases within its primary metastasis-free survival endpoint. This reflects modern imaging practice, but PSMA-PET-based MFS has not yet been validated as a surrogate for overall survival. As our imaging becomes more sensitive, we must ensure that our clinical endpoints remain meaningful for patients.

🔹 Patient selection remains the key question. High-risk prostate cancer is not a single disease. The future lies in identifying the patients who truly benefit from treatment intensification through better biological and molecular stratification, rather than applying a “one-size-fits-all” approach.

PROTEUS is undoubtedly a landmark trial. However, its greatest contribution may not simply be demonstrating that “more treatment is better,” but rather opening the door to a more nuanced discussion about who should receive intensified therapy, how we should measure success, and how we can personalize treatment for patients with high-risk localized prostate cancer.

euoncology.europeanurology.com/article/S2588-…

#ProstateCancer #Urology

@GiuliaMarvaso84 @CMercinelli @GGandaglia @PBlanchardMD @roodvdb @GGiannarini @MRoupret @EurUrolOncol @Lara__Rodriguez @foxal72

This guideline is absolutely terrific. Evidence-based (though high-level evidence is scant), reasonable and practical for the clinic.

For truly curative-intent cases, I tend to favor hyperfractionation given the NPC data, but one must acknowledge the limitations in extrapolation.

Terrific work from an all-star panel.

Happy to share our latest review in @TheLancetOncol on Head & Neck cancer reirradiation

with @BiauJulian @sueyom @arnaud_beddok among others @ESTRO_RT @ASTRO_org @H_N_C_I_G

free author's link: authors.elsevier.com/c/1nM825EIIgXF…

‼️ INDIBLADE: stage II/III (cT2-4aN0-2) MIBC -> induction ipilimumab plus nivolumab -> CRT

2-year bladder-intact event-free survival is 78% (0.67−0.9) 🤩

2-year overall survival was 96% (0.91−1)

Lots of bladders can be potentially spared!

nature.com/articles/s4159…

The Green Journal is on LinkedIn, very active.

Just celebrating our 10k followers.

Follow us there if you want updates on our articles, special issues, new sections, and more!

linkedin.com/showcase/green…

cc @ESTRO_RT

I really recommend this evidence based critical analysis of PROTEUS @NEJM article (available here: nejm.org/doi/full/10.10…).

This is a big trial, but with many issues (control arm, primary endpoint, effect size...) that may not translate into meaningful patient benefit #ASCO26

#ASCO26
The PROTEUS trial results are now online...buckle up as we wait to see the full presentation. This is going to be a trial that is likely highly controversial until the full results are published.

Some may call this a homerun, others may call this the largest negative trial @ASCO 2026. Up to you to interpret!

@urotoday @EricTopol @DrChoueiri @neerajaiims @ASCO @US_FDA @NCCN @myESMO @ASTRO_org @PCF_Science @declangmurphy @mcuban

🚨The June 2026 issue of the Green Journal (@RO_GreenJournal) is out:

thegreenjournal.com/issue/S0167814…

The HEAT trial is another randomized demonstration of the safety & efficacy of SBRT compared to hypofractionted RT in #prostatecancer at #ESTRO26

No QoL difference with IMPT vs IMRT in oropharyngeal cancer in the TORPEdO 🇬🇧 trial.
How to explain the differences w/ @SJFrankMD 🇺🇸 trial? Planning? Patients? Crossover in the 🇺🇸 trial? Real absence of difference?

Cc @EmmaHall71 @

Yesterday, I presented the @GETUG_Unicancer PEACE 2 trial at #ESTRO26 on the role of pelvic RT in very high risk #prostatecancer pts (staged with conventional imaging).

Twittorial below

Key conclusion: pelvic RT did not improve clinical outcomes (cPFS, MFS, PCSS, OS)...

1/n

EFFICACY:

No interaction btw cabazitaxel & pelvic RT effects, hence arms were pooled.

NO difference in efficacy with pelvic RT (except a small non significant improvement in cPFS), even in pts at high risk of nodal disease (Roach>35%)

4/n

Conclusion:
Pelvic RT is NOT SOC in #prostatecancer pts, even at high risk of nodal disease, staged with CI.

We need to improve risk stratification to escalate/deescalate according to individual risk. But the notion of vHR prostate cancer may need to be redefined.

5/5

Hypofractionated pelvic radiotherapy is safe & well tolerated.
Prof Syndikus presentation of the PIVOTAL BOOST trial at #ESTRO26

Similariy, in the PIVOTAL BOOST trial, concomitant Boost (up to 67/20) is safe & well tolerated.
Prof Syndikus presentation of the trial at #ESTRO26