Ajaz B.

'Oncologist'

Passionately trying to bridge the cancer care gap in America

[Erika Hamilton, MD, FASCO @ErikaHamilton9]

Ok- now we are up to 4 options in ESR1m 2nd line MBC:
Elacestrant
Imlunestrant
Imlunestrant + abema
Vepdegestrant

Great to have a combo option!

https://t.co/P9JavZNzVd

[Stephen V Liu, MD @StephenVLiu]

Dr. @JuliaRotow at #WCLC26 with primary results from DESTINY-Lung04: first-line trastuzumab deruxtecan vs platinum + pemetrexed + pembro in advanced HER2 mutant NSCLC. Primary endpoint of PFS favors T-DXd at 14.3 vs 8.3m, HR 0.63 and RR 70% vs 44.5%, DOR 13.7 vs 9.7m, PFS2 22.7 vs 17.3m.

[Stephen V Liu, MD @StephenVLiu]

Landmark, practice changing study at #WCLC26. The phase III MAVERICK study shows no improvement in OS with PCI for SCLC, across limited and extensive stages, with worse cognitive failure free survival and increased toxicity in PCI arm.

The end of the PCI era.

[Paolo Tarantino @PTarantinoMD]

Just out in @NEJM, the results of ASCENT-04, by @stolaney1 et al. Among patients with PD-L1+ mTNBC, first-line SG/pembro significantly improved PFS (11.2 vs 7.8 months, HR 0.65, p<0.001) compared with chemo/pembro. New standard of care for this population. https://t.co/cjlf6z3x4r

[kilian jornet @kilianj]

If you made some strong resolutions for 2026, they will probably not stay for long. Instead build a solid routine you can sustain easily and build slowly from there. You can be occasionally flexible to ensure that consistency lasts.

[Yukinori Ozaki, MD, Ph.D @YukinoriOzaki]

Overview of SABCS2025 Breast Cancer topics!! Merry Christmas🎄 #SABCS25
@Ganken_hosp Thanks for @kazuki_nozawa @MamMa_mimumemo @shimoi_oncology
@OncoAlert @GustaveRoussy
#BreastCancer #SABCS

[Jason A. Mouabbi MD @JAMouabbi]

#SABCS25 Recap #1 | HER2CLIMB-05

HER2CLIMB-05 showed that adding #tucatinib to maintenance HP after 4–6 cycles of THP improved mPFS to ~24 months in mHER2+ BC.

Here is my take:

1️⃣ HR+ subgroup
I would still favor #PATINA (HP + ET + #palbociclib) for maintenance:

PATINA: mPFS ~45 months (∆ +15 vs HP)
HC-05 (HR+): mPFS ~25 months (∆ ~7 vs HP)

2️⃣ Post-DB09 reality
With #DESTINYBreast09 moving SoC toward T-DXd + pertuzumab, maintenance only makes sense if it’s less toxic than induction.
HC-05 reported ~43% grade ≥3 AEs 👉 high, in my view.

@OncoAlert @OncBrothers @breastfriendspd

[Dr Rishabh Jain @DrRishabhOnco]

🚨 FDA approval that changes early prostate cancer care 🧬

For the first time, a PARP inhibitor moves into mCSPC.
FDA approves niraparib + abiraterone + prednisone (AKEEGA) for BRCA2-mutated mCSPC 🏆

📊 AMPLITUDE trial signal
🧠 rPFS HR 0.46 in BRCA2m
📉 Median rPFS not reached vs 26 months with abiraterone alone
👉 Benefit driven almost entirely by BRCA2 mutations

💡 Takeaway
Early molecular stratification now directly guides first-line therapy in mCSPC.
BRCA2 testing is no longer optional 🔍

#ProstateCancer #OncoTwitter #PrecisionOncology @OncoAlert @myesmo @esmo_open @ASCO

[Ilana Schlam @IlanaSchlam]

In 2025, many important and long-awaited studies were published. I included them but kept the algorithms unchanged, as there are open questions about how these data will impact practice, particularly in early and metastatic HER2+ disease and mTNBC.
@DFCI_BreastOnc #SABCS25

[Dr Rishabh Jain @DrRishabhOnco]

At #SABCS25, the message in mTNBC is loud and clear 🔊

🧬 TROP2 ADCs are moving upfront
Sacituzumab govitecan and Dato-DXd are emerging as preferred early-line strategies, not late rescues

⏳ Why it matters
Nearly 50 percent of patients never reach 2L therapy
Delaying the most effective drug means losing the chance to use it

🔄 Sequencing insight
Early data suggest ADC-to-ADC sequencing may work, even with similar payloads
Resistance is not absolute and biology still matters

🎯 What’s next
Biomarker-guided selection is critical in this heterogeneous disease
Beyond TROP2, new ADC targets are urgently needed

#OncoTwitter #MedTwitter #BreastCancer #SABCS25 @OncoAlert @myesmo @esmo_open @stolaney1

[Dr Rishabh Jain @DrRishabhOnco]

ASCENT-07: When Hope Meets Hard Data 🛑 #SABCS25

We expected sacituzumab to rise in 1L post endocrine therapy HR+/HER2- disease. The trial reminded us that biology is not easily overturned.

📉 The Miss
• No mPFS gain by BICR
• 8.3 mo vs 8.2 mo
• HR 0.85, not significant

💊 The Surprise
Capecitabine stood firm, proving standard chemo still has real muscle.

🧭 Implication
SG does not move into 1L post endocrine therapy.
Chemo or T-DXd for HER2 low or ultra low remains the smarter play.
Save SG for when it truly matters.

#BreastCancer #OncTwitter #MedEd @OncoAlert @SABCSSanAntonio

[Elvina Almuradova @Dr_ElvinaA]

DESTINY-Breast05 results published in NEJM!
T-DXd significantly improves 3-year IDFS (92.4% vs 83.7%; HR 0.47) and reduces distant recurrences (5.1% vs 9.9%) over T-DM1 in high-risk residual HER2+ early breast.

❗️But ILD remains a major concern (9.6%, incl. 2 deaths) and OS data are still immature.
Practice-changing, yes—yet we must be very careful in patient selection and monitoring.

#BreastCancer #HER2 #SABCS2025 @Larvol @NEJM @brunolarvol @OncoAlert @MedicalwatchHQ @OncLive

[Dr Rishabh Jain @DrRishabhOnco]

💥 AMBRE drops a practice changing signal at #SABCS25
High visceral burden ER positive HER2 negative ABC patients did better on upfront ET + abemaciclib than chemotherapy.

🧬 Who enrolled?
Strict high burden criteria
➡️ 2 or more visceral sites
➡️ or 3 or more lesions in one site
➡️ or 1 visceral site + high LDH

🎯 Main result
➡️ mPFS 13.9 vs 7.0 months
➡️ HR 0.67, p=0.035
➡️ No new safety signals

🩸 CTC story
Baseline similar.
But at 3 weeks, conversion to low CTC count was higher with ET + abemaciclib
➡️ 52 percent vs 38 percent (p=0.049)
Early CTC drop mirrors clinical benefit.

💡 Takeaway
ET + abemaciclib should be a first line option in ER positive HER2 negative ABC with strict high visceral burden.
A shift away from mandatory chemotherapy in this subgroup.

#OncoTwitter #MedTwitter #BreastCancer @OncoAlert @myesmo @esmo_open @asco @SABCSSanAntonio

[Oncology Brothers @OncBrothers]

#SABCS25 Day 2 Highlights:

1. #lidERA: SERD in Adj HR+

2. #ALLTO: Adj ET in HR+/HER2+

3. #ASCENT07: Saci in HR+ mBC

4. #HER2Climb05: Tucatinib in 1L HER2+ mBC

5. #DB11: TDXd in NeoAdj Her2+

6. #DB05: TDXd in Adj Her2+

@SABCSSanAntonio #bcsm #OncTwitter @OncoAlert

1/7

[Paolo Tarantino @PTarantinoMD]

Tremendous algorithm by @antgiorda!

[Uğur Özkerim @UOzkerim]

🚨 After the remarkable EV+P results in mUC, mastering its toxicity profile is no longer optional.
Skin reactions, neuropathy, ILD, and hyperglycemia demand early recognition & proactive management.
Safety = efficacy in the ADC–IO era
@OncoAlert

[OncUpdates @OncUpdates]

#ESMO25 Highlights!

#KEYNOTE905: PeriOP EV + Pembro in cis-ineligible MIBC followed by postOP EV + Pembro:

🎯EFS At 2yrs: 74.7% vs. 39.4%
📈EFS HR: 0.40
✅OS at 2yrs: 79.7% vs. 63.1 (HR: 0.50)

#MedTwitter #OncTwitter #OncTwitter #MedX

[Vincent Rajkumar @VincentRK]

Breaking:
And I’m glad. This is an important option we need for patients with myeloma.

FDA has approved belantamab in combination with bortezomib and dex (BVd) for relapsed or refractory multiple myeloma in patients who have received at least two prior lines of therapy, including a proteasome inhibitor (PI) and an immunomodulatory (IMID) agent.

https://t.co/yPbZzjPXt5

[Mirrors of Medicine @mirrorsmed]

ASCENT-03: Sacituzumab Govitecan in Untreated, Advanced Triple-Negative #BreastCancer

https://t.co/EYwolY1g75

Presented at #ESMO25 : Finds In patients with advanced triple-negative breast cancer ineligible for PD-1 or PD-L1 inhibitors, sacituzumab govitecan significantly improved progression-free survival and response durability compared to standard chemotherapy, with a similar safety profile.

@JavierCortesMD
@kevinpunie
@breastoncdoc
@MOliveira_MD
@stolaney1

[Vincent Rajkumar @VincentRK]

Updated mSMART guidelines on treatment of newly diagnosed myeloma.

Major change: For standard risk myeloma, doublet maintenance (lenalidomide plus anti CD38) recommended if MRD+ post transplant.

https://t.co/R4hz7ulYPb