Margaret Van Meter, MD

Medical oncologist @Intermountain, Director of Breast Oncology. Clinical research, quality improvement, cardio-oncology, provider wellness. All tweets my own.

[Margaret Van Meter, MD @MVanMeterMD]

Discussion of emerging treatment options in HR+/HER2- metastatic breast cancer.
EMBER-3, evERA, and ASCENT-07
Nick Turner of @royalmarsdenNHS #SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

evERA subgroup analysis: oral SERD giredestrant or SOC ET + everolimus after prior CDK4/6i. 55% with mESR1. 47% prior fulvestrant. Benefit maintained in PIK3CA/AKT1/PTEN pathway alteration, prior CDK4/6i.
@hoperugo of @cityofhope #SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

EMBER-3 update: imlunestrant after progression on first-line AI+/-CDK4/6i. Median follow-up 28 mo.
*OS benefit 11.4 mo in imlun. alone, across subgroups
*PFS benefit imlun+abema in CDK4/6i-pretreated; OS trend
https://t.co/DFgNSB2eQS
@jhaveri_komal @MSKCancerCenter #SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

WISDOM: smarter screening, not more screening

Risk-based breast cancer screening, age 40-74, no prior breast cancer. No increase in stage >=2B or 2A. Fewer mammos in risk-based arm. 77% completed genetic
testing.

https://t.co/8ih7DyLAyI

Laura Esserman @UCSFSurgery #SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

Real and sham accupuncture for cognitive difficulties in breast cancer survivors. 10 weekly sessions, 20-30 min, focused on sleep, cognition, other symptoms. Subjective improvement in both groups vs usual care; objective improvement in real.
@JunMaoMD @MSKCancerCenter #SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

YES: ePRO/chat room/journal tool in AYAs <3 years from end of active treatment for breast cancer, emphasizes self-management and self-monitoring. Improved QoL, no significant change in depression/anxiety. Some symptoms improved.
@AnnPartridgeMD @DFCI_BreastOnc #SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

PREFER: explored factors associated with acceptance of fertility preservation measures in women with early breast cancer. No difference in breast cancer outcomes in those who received controlled ovarian stimulation for oocyte cryopreservation.
@matteolambe @SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

Matched prospective study: breast cancer incidence not increased in BRCA1/2 carriers who used menopausal hormone therapy after rrBSO; lower incidence in estrogen alone group. No difference by route or type of E/P. Still knowledge gaps.
Joanne Kotsopoulos of @WCHospital #SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

EA1183: Use of FDG-PET/CT and mPERCIST criteria for assessment of treatment response in breast cancer with bone metastases.
@eaonc
@drjenspecht of @fredhutch #SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

Lower incidence of brain metastases in patients with HR+ HER2+ metastatic breast cancer treated with palbociclib in addition to HER2-targeted therapy in the PATINA trial. No scheduled CNS imaging surveillance in the trial.
@Otto_DFCI @DFCI_BreastOnc #SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

Tour de force review of treatment of metastatic TNBC by @stolaney1 of @DFCI_BreastOnc. A few key points below, but highly recommend watching the entire session!
#SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

Adjuvant radiation in non-low-risk DCIS

HR 0.49 with boost, benefit across subgroups
No difference in OS

3 randomizations, each evaluating +/- boost
median follow-up 10.2 yrs
Majority age 50+, unifocal, <=2 cm, margins 2+ mm

Boon Chua @BIGxResearch @TROGfightcancer
#SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

Omission of SLN in cT1-2 N0 treated with BCS
83% cT1
87% HR+ HER2-
52% received no adjuvant systemic therapy
5 year regional recurrence free survival noninferior
Follow-up ongoing
Marjolein Smidt @MaastrichtUMC #SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

DCIS patient education resources

[Margaret Van Meter, MD @MVanMeterMD]

Excellent discussion of low-risk DCIS management by @DrEricWiner @SmilowCancer #SABCS25

*No RCT of DCIS treatment has ever shown OS benefit
*Do as little as possible without compromising safety in any way
*No "right choice" - patient preference is key

[Margaret Van Meter, MD @MVanMeterMD]

A011104: Breast MRI does not improve locoregional recurrence rates in prospective RCT. No differences by age or tumor subtype. Also no difference in distant recurrence or overall survival.

Isabelle Bedrosian of @MDAndersonNews
#SABCS25 @ALLIANCE_org

[Margaret Van Meter, MD @MVanMeterMD]

Multimodal multitask deep learning model using H&E images and clinical features is prognostic for distant recurrence in HR+ breast cancer independent of treatment. Not predictive of treatment benefit.
Terry Mamounas #SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

Presence of ctDNA in the PALLAS study is strongly prognostic for recurrence in early breast cancer. Await additional data on impact of CDK4/6i in reducing recurrence.
@hthrparsons of @fredhutch #SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

Discussion by @DrLisaCarey lidERA data
*First positive data for adjuvant SERD; other studies ongoing
*No data yet in patients treated with full course of adjuvant CDK4/6i
*Cost of giredestrant could be substantial - perhaps >$20,000 per month.
#SABCS25

[Margaret Van Meter, MD @MVanMeterMD]

lidERA: adjuvant oral SERD and ER antagonist giredestrant vs ET. 40% premenopausal, 50% stage II, 40% stage III. 80% received prior chemo. 3-yr IDFS 92.4% vs 89.6%, HR 0.70. Benefit across subgroups. DRFI improved, HR 0.69. OS immature.
@dradityabardia #SABCS25