Ana Zilic

[Dr Sarah Sammons @drsarahsam]

🚨 BREAKING: FDA approves palbociclib + trastuzumab ± pertuzumab + ET as 1L maintenance in HR+/HER2+ metastatic breast cancer based on #PATINA! @Otto_DFCI

Median PFS 44.3 vs 29.1 months a >15-month gain for adding a CDK4/6i to anti-HER2 + endocrine therapy after induction. (Any induction approved).

The first phase III trial to show benefit of CDK4/6 inhibition in HR+/HER2+ MBC. #bcsm

[Dr Amol Akhade @SuyogCancer]

🚨 Breaking:
Datopotamab-Deruxtecan (DATROWAY) from Daiichi Sankyo & AstraZeneca meets both co-primary endpoints — OS + PFS — in 1L metastatic TNBC (IO-ineligible).
➡️ First ADC ever to show a clinically meaningful OS benefit vs chemo in this setting.
Meanwhile, Sacituzumab Govitecan (Trodelvy) in ASCENT-03 showed PFS benefit but no OS detriment - Does that mean No OS ?? — full data for both awaited at #ESMO25.
We now have 4 TOPO-I ADCs shaping the mTNBC landscape:
1️⃣ Sacituzumab Govitecan (TROP2 | SN-38)
2️⃣ Datopotamab Deruxtecan (TROP2 | DXd)
3️⃣ Sac-TMT (TROP2 | TMT payload, 🇨🇳 approved)
4️⃣ Trastuzumab Deruxtecan (HER2-low | DXd, post-chemo HR⁺ MBC only)
Same payload class. Overlapping targets. No clear sequencing roadmap.
So ultimately it will come down to 👇
🎬 “It’s not the plane, it’s the pilot.” — Top Gun: Maverick
Onus will be on oncologists — choosing the right ADC for the right patient, in the right sequence.
#mTNBC #ADC #Oncology #esmo2025

[Yakup Ergün @dr_yakupergun]

ONS/ASCO Guideline on the Management of Antineoplastic Extravasation

https://t.co/8XIz2fYs02

[Susan G. Komen @SusanGKomen]

Learn more about HER2+ MBC & the latest breakthroughs in research, clinical trials & treatment strategies at our upcoming MBC Impact Series.

🗓️ Sept 17: 1pm CT

Register today: https://t.co/q2gUKcnkoz

Thank you to our partner @AstraZeneca for supporting the MBC Impact Series.

[Paolo Tarantino @PTarantinoMD]

ctDNA analysis of SONIA published on @NatureMedicine. 34% of the patients had high ctDNA before entering the study, and derived a PFS2 benefit from an early (first line) use of CDK4/6-inhibitors. Patients with low ctDNA, instead, derived no benefit. https://t.co/9DMLLo8lOn

[Elvina Almuradova @Dr_ElvinaA]

Is primary tumor resection for metastatic breast cancer worth it? A new randomized trial offers key insights:

👉No OS benefit for all patients.
👉Significant benefit in local relapse-free survival (20 vs. 63 months).
👉Potential survival benefit in pre-menopausal and single-organ metastasis subgroups.

This trial reopens the debate on local control.
Would you now consider primary tumor-directed therapy for your patients with metastatic breast cancer?
@Larvol @SuyogCancer @dr_yakupergun @OncoAlert
#BreastCancer #OligometastaticBC #CancerResearch

[BreastCancersToday @BreastCancersTd]

@adawaksmd @DanaFarber discusses ShortStop-HER2, testing 6 vs 12 months of HER2 therapy after pCR in early-stage breast cancer: Can shorter therapy maintain efficacy while improving QoL & reducing toxicity? Watch: https://t.co/E4rz1Xf0Ww @PTarantinoMD @drsarahsam @ALLIANCE_org

[Yakup Ergün @dr_yakupergun]

We often debate whether ET should last 5, 7, or 10 years, yet toxicity seems to be treated as a secondary issue. Although ET agents may appear relatively harmless, their long-term use brings along a wide range of adverse effects.

Great review👇

https://t.co/BGArEgCUQz

[Komal Jhaveri, MD, FACP, FASCO @jhaveri_komal]

Fantastic news for patients! OS benefit with adjuvant abemaciclib for 2 years for high-risk node positive patients. Congratulations to everyone involved with the monarchE trial. Awaiting details at an upcoming meeting.

https://t.co/X6woNB4dwK

[Yakup Ergün @dr_yakupergun]

mFOLFIRINOX or S-IROX vs Nab-Paclitaxel + Gemcitabine in Metastatic or Recurrent Pancreatic Cancer (GENERATE, JCOG1611)

💥mFOLFIRINOX or S-IROX was not found to be superior to gem+ nab-pac; in fact, gem+nab-paclitaxel showed numerically better outcomes

https://t.co/LG1K6eyKVt

[Paolo Tarantino @PTarantinoMD]

Great retrospective study on post-T-DXd outcomes for HER2+ mBC — congrats @kazuki_nozawa!

[Eric K. Singhi, MD @lungoncdoc]

Huge thanks to @BalazsHalmosMD and team for publishing this incredibly important manuscript. If you’re prescribing or starting Dato-DXd, this is a checklist you’ll definitely want to BOOKMARK or even PRINT out! 👇🏽👇🏽

@EGFRResisters @OncoAlert @OncBrothers @LungCancerRx

[Yakup Ergün @dr_yakupergun]

In early-stage TNBC patients treated with pembrolizumab + chemotherapy:Neo-Real/GBECAM 0123

🔹 Overall irAE rate: 31%
🔹 G≥3 irAEs: 13.6%

📌 Neoadjuvant phase:
• Any irAE: 22.6%
• G≥3: 8.4%

📌 Adjuvant phase:
• Any irAE: 11.3%
• G≥3: 3.2%

💬In KN-522, the 5-y OS benefit in patients who achieved pCR was only 0.7%.
Considering the toxicity burden, is adjuvant pembrolizumab truly necessary in patients with pCR?

https://t.co/66JCcyuAZO

[Yakup Ergün @dr_yakupergun]

An excellent guideline on the management of adverse events associated with Dato-DXd👇

[Yakup Ergün @dr_yakupergun]

Pregnancy after breast cancer: latest evidence and practical considerations

A grest summary of practical matters👇

https://t.co/bgI1BQUzUy

[Yakup Ergün @dr_yakupergun]

Overcoming resistance to CDK4/6 inhibitors in hormone receptor positive, HER2 negative breast cancer: Innovative combinations and emerging strategies

https://t.co/2mgtx0AVjF

[Paolo Tarantino @PTarantinoMD]

BMI analysis of ASCENT. Overweight/obese pts experienced higher rates of serious AEs (34% vs 18%) with SG and 41% of obese pts required dose reduction (vs 10%). Should we cap the dose of SG for overweight/obese pts, similar to other ADCs (eg EV, Dato-DXd)? https://t.co/yycMqutFw1

[Dr Sarah Sammons @drsarahsam]

Destiny-Breast-09 will likely establish a new first-line therapy for HER2+ MBC. Here are my considerations going into #ASCO25

Patient population considerations:
1) De novo patients (capped at 50%): these patients are more likely to respond durably and possibly even be cured in a small subset. In CLEOPATRA around 15% of patients never relapsed at 8 years. Can we do better and where will the curve flatten? We will need longer term follow up for this question.

2) Recurrent patients: these patients relapsed despite trastuzumab and chemotherapy in early-stage setting. These patients are more likely to need escalation to T-DXd in front-line in my opinion given resistant disease.

3) Estrogen Receptor Status: how did the ER+ versus ER- patients do? We now have PATINA with a 44 month PFS in ER+ patients with a chemotherapy-free regimen. How will we reconcile this? How many got endocrine therapy on trial.

4) What was the time on treatment? How long did patients actually stay on T-DXd and how many stopped for treatment toxicity? It’s not an easy drug which deserves consideration.

5) Difference in grade 3-5 toxicity between arms? This is a first-line population who can get T-Dxd in the second-line, QOL matters!

6) PROs: How do patients feel on continuous chemotherapy for years versus a previously established, EXTREMELY well tolerated chemo-free maintenance strategy.

Ultimately, we will need to understand the benefits of first-line versus second-line T-Dxd.

Are we having more long-term responders (cures?), are people living longer, is toxicity acceptable?
Time will tell beyond this exciting presentation.

#bcsm

[Yakup Ergün @dr_yakupergun]

The role of cardioprotectives in anthracycline-treated patients

💥In the SAFE trial, ramipril/bisoprolol reduced subclinical cardiotoxicity from ~40% to ~10% in anthracycline-treated BC patients with no baseline cardiac risk.

Prevention matters!!

https://t.co/FcV5uZvhi7

[Yakup Ergün @dr_yakupergun]

Zoledronic acid vs. Denosumab in HR+/HER2- aBC with bone mets + CDK4/6i

🔍PSM/IPTW-adjusted retrospective study

🔹ZA prolonged time to 1st SRE vs. DMAB

🔹No difference in PFS or OS between groups

💥ZA might be preferred in this setting despite prior RCTs favoring DMAB?

https://t.co/vwmHyHpTWe