Pedro Exman MD, PhD

👨‍⚕️Oncologista no @hospitalalemao-especializado em câncer de mama,👨‍👩‍👦‍👦pai do Alê, Gui e do Lipe, marido da Monique. ⚽️Corinthians e 🏈Patriots

[Pedro Exman MD, PhD @PedroExman]

@DrHBurstein @DanaFarber 👏🏻

[Pedro Exman MD, PhD @PedroExman]

@PTarantinoMD Would be great to have NGS test. pik3CA mutation would guide my choice. If +, TDxd upfront. If not, PATINA-like scheme

[Paolo Tarantino @PTarantinoMD]

Unforgettable lecture by @stolaney1, awarded with the @AACR Outstanding Investigator Award. Her impact on cancer research, leadership, mentorship and pts lives cannot be summarized in a tweet, nor in a thousand. We’re immensely lucky to follow her bright lead at @DFCI_BreastOnc!!

[Pedro Exman MD, PhD @PedroExman]

Good time to revisit this post. I would add:
•Maintenance therapy is here to stay.

• PATINA data seem particularly compelling in HR+/HER2+.

•The lack of a statistically CNS benefit with tucatinib is, unfortunately, quite surprising.

#SABCS25 @OncoAlert #bcsm

[Pedro Exman MD, PhD @PedroExman]

Precision oncology has reached HER2+ metastatic breast cancer — and additional data on DB09 backs it

🔹 PIK3CA mut → T-DXd, regardless of HR status (🧐?)

🔹 PIK3CA WT →
 • HR+ → PATINA-like
 • HR− → T-DXd (🤔?)

IHC+NGS may guide up-front choices.

@OncoAlert #bcsm

[Sara Tolaney @stolaney1]

Please watch @DFCI_BreastOnc #BreastCancerBreakthroughs and learn about new findings in breast oncology. You can learn more at our post-ESMO webinar hosted by @DrHBurstein on Friday, November 14th at 1:30pm EST; register for free here: https://t.co/mxb5J99F9J

[Sara Tolaney @stolaney1]

Absolutely AMAZING discussion by Ana Garrido-Castro on ASCENT-03 and TROPiON-Breast02!!!

@DFCI_BreastOnc #ESMO25 @OncoAlert

[Pedro Exman MD, PhD @PedroExman]

Precision oncology has reached HER2+ metastatic breast cancer — and additional data on DB09 backs it

🔹 PIK3CA mut → T-DXd, regardless of HR status (🧐?)

🔹 PIK3CA WT →
 • HR+ → PATINA-like
 • HR− → T-DXd (🤔?)

IHC+NGS may guide up-front choices.

@OncoAlert #bcsm

[Pedro Exman MD, PhD @PedroExman]

🙂🙃 Exciting DB05 data — cure rates keep improving!

🔑 For residual post-neoadj disease, treatment escalation with better drugs is needed.

🚨 Fewer patients complete T-Dxd treatment. For lower-risk residual disease, should we do fewer cycles of Txd ?

@OncoAlert @myESMO

[Pedro Exman MD, PhD @PedroExman]

Despite the increasing complexity in managing pts after progression on CDK4/6i, these data consolidate that 2nd-line treatment should combine targeted therapy rather than ET monotherapy.

#ESMO25 confirms that next trials should not use isolated fulv as control arm

@OncoAlert

[Pedro Exman MD, PhD @PedroExman]

While concerns about the absolute benefit (1.8%) and NNT~50 with adj abema are valid and deserve consideration, the key takeaway may lie in the consistent DRFS gain.

HR 0.75 in distant disease or death is meaningful.

The data is clear — and so is my choice.
@OncoAlert #ESMO25

[Pedro Exman MD, PhD @PedroExman]

DFS in the control arm in N0 pts continues to demonstrate meaningful decline — underscoring that these pts may be truly high-risk.

Updated results show a consistent benefit of ribo in this subgroup.

Tumor biology matters to choose wisely the treatment!

@OncoAlert
#ESMO25

[Sara Tolaney @stolaney1]

monarchE OS w/adj abema--> statistically significant improvement in OS at 7 yrs
OS HR 0.842, p=0.0273; benefit seen across subgroups
iDFS: HR 0.734
DRFS HR 0.746

CDK 4/6i 1L MBC: 47.3% in abema vs 30.0%
If early recurrence 44% on abema arm recv'd chemo in 1L
@myESMO #oncoalert

[OncoAlert @OncoAlert]

Impact of the Prosigna assay on neoadjuvant treatment decision-making in patients with early-stage HR-positive/HER2-negative breast cancer: a single-center prospective observational study

https://t.co/ll0TDJxpKt

This prospective single-center study evaluated whether the Prosigna 50-gene assay, typically FDA-cleared for postoperative hormone receptor-positive (HR-positive) #BreastCancer could impact neoadjuvant treatment decisions when performed on core biopsy specimens. Among 54 patients with early-stage HR-positive/HER2-negative breast cancer, treatment plans changed in 35.2% of cases after Prosigna results, primarily based on risk of recurrence (ROR) and intrinsic subtype. The assay also bolstered physician confidence in 83.7% of cases and reduced patient anxiety in 62.5%. These findings suggest that using Prosigna in the preoperative setting may meaningfully guide treatment planning and support shared decision-making.

OncoAlert Breast Cancer Faculty
@matteolambe @aftimosp @E_de_Azambuja @double_whammied @stage4kelly @coffeemommy @itsnot_pink @maryam_lustberg @IBCResearch @nicolobattisti @raalbany @hoperugo @teamoncology @stolaney1 @LoiSher @jamecancerdoc @JaniceTNBCmets @itrisabel

#OncoAlertAF
@nataliagandur @acampsmalea @BRicciutiMD
@yekeduz_emre @HHorinouchi @FadiHaddad_MD
@Abdallah81MD @FernandoOnco
@ElisaAgostinett @to_be_elizabeth @bavilima @realbowtiedoc @Erman_Akkus @Lucarecco @GaiaGriguolo @JankovicK
@MarioBalsaMD @DrMirallas @GIMedOnc @OscarTahuahua

[Pedro Exman MD, PhD @PedroExman]

Great work, Chiara!

Grateful to kick off this project and, as always, learn alongside @stolaney1 and @nlinmd.

Personalized care is the future — every patient deserves a tailored approach.

Thank you Sara, Nancy and Chiara. @DFCI_BreastOnc

🤓🔬

[Chiara Corti @CCortiMD]

Pleased to share the results of our prospective observational decision-impact study in early-stage HR+/HER2− breast cancer (NCT03749421).
🔗https://t.co/CzNzYWDcdn
🧵👇

[Sara Tolaney @stolaney1]

What an honor to have @lab_kok as the Schlager lecturer at #HarvardBreastCancerCourse. She gave an amazing talk and shared her vision for immunotherapy in early TNBC.

@DFCI_BreastOnc

[Paolo Tarantino @PTarantinoMD]

Three key practice changing trials at #ASCO25, one for each subtype of breast cancer. Things are moving FAST!!!

[Paolo Tarantino @PTarantinoMD]

With ASCO25 wrapping up, I wanted to acknowledge the impact of a person that— between leading @DFCI_BreastOnc, caring for patients, mentoring countless physicians, parenting 2 teenagers — also led 2 trials that will impact lives for thousands of pts globally. Congrats @stolaney1!

[Pedro Exman MD, PhD @PedroExman]

🚨 Hot take: Among so many studies, OASIS might have the biggest *immediate* impact on pts' lives.

It tackles a side effect that drives poor adherence in breast cancer.

Would love to see discontinuation rates by arm.

We need Elinzanetant available ASAP.

#bcsm @OncoAlert

[Pedro Exman MD, PhD @PedroExman]

@DrHBurstein Alopecia is also an underestimated adverse event.
Scalp cooling (cryotherapy) can work reasonably well for weekly IV paclitaxel

This adverse event data should also be evaluated with this new oral drug.

[Dr Sarah Sammons @drsarahsam]

First-line Sacituzumab + Pembrolizumab improves PFS in 1st Line TNBC. 🚨🔔‼️

Crossover 80% Sacituzumab Offered!

Very few patients with prior IO, few who relapsed within 6-12 months.

OS looks similar but early days.

#bcsm great job @stolaney1 !!