Kirstin Spencer

Mother, Teacher, Equestrian, Musician, Patient Advocate, LIVING with Stage 4 Breast Cancer.

[Harold J. Burstein, MD, PhD, FASCO @DrHBurstein]

Vepdegestrant approved, joining elacestrant and imlunestrant as monotherapy options for ESR1 mutated, advanced breast cancer.

[Mali Barbi, MD MSc | Breast & Gyn Oncologist @DrBarbiOnc]

Today’s #Pfizer release for the #atirmociclib (#FOURLIGHT-1) trial is a significant clinical signal, but the real value lies in the strategy it validates: the "Molecular Switch." By targeting selective #CDK4 inhibition, Pfizer achieved a 40% reduction in the risk of progression or death (HR = 0.60, p=0.0007) in patients who progressed on prior #CDK4/6 within just 3 months.
This drug differs fundamentally from the "Big Three" (palbo, ribo, abe) because it is CDK4-selective. By sparing CDK6, it avoids heavy bone marrow toxicity that often causes treatment delays (only 6.4% discontinuation rate), suggesting a gentler safety profile.
However, the critique remains: we are still delaying resistance, not eliminating it. The next challenge is identifying which patients benefit from this selective approach versus those who should proceed directly to an ADC.
#BCSM #breastcancer @ASCO @OncoAlert
Pfizer Announces Positive Topline Phase 2 Results for Next-Generation CDK4 Inhibitor, Atirmociclib, in Second-Line Metastatic Breast Cancer - https://t.co/COXDaxEI4I

[Kirstin Spencer @kjscello]

@sophieRblake It is such a shame and a hard grief to carry, Sophie. The death toll from metastatic breast cancer is relentless. Courage to us all as we continue to witness so many lives lost.

[Kirstin Spencer @kjscello]

Special session amplifies dialogue on lobular breast cancer https://t.co/eGSOeu5T5n

[Hope Rugo @hoperugo]

#SABCS2025 Francois-Clement Bidard presents updated Serena-6 data. PFS2 and time to ADC/Chemo better with early switch, ctDNA mESR1 fraction decreased. Remaining question is early vs later switch with lack of xover. @OncoAlert

[Hope Rugo @hoperugo]

#SABCS2025 Veronique DIeras presents the beautiful data from the Ambre trial comparing ET/abema to chemo in pts with higher risk MBC 1st line. Doubling of PFS clear with ET combo - this IS the SOC except true visceral crisis- ET/CDKi 1st line MBC. @OncoAlert

[Kirstin Spencer @kjscello]

@Matt_Pinner This is too easy 😆

[Dana-Farber’s Breast Oncology Center @DFCI_BreastOnc]

The DESTINY-Breast09 phase 3 trial results are now available in @NEJM! The study evaluated #TrastuzumabDeruxtecan plus #Pertuzumab for HER2+ #MetastaticBreastCancer and found that trastuzumab deruxtecan plus pertuzumab showed a significant benefit in progression-free survival as compared with THP in advanced or metastatic HER2+ #BreastCancer, a benefit that was consistently observed across most patient subgroups.
🔓https://t.co/un0eOhBlmO
@stolaney1 @ToiMasakazu #BD09

[Kirstin Spencer @kjscello]

@Dr_RShatsky Is there not an epidemic of stage 4 cancer patients dying under pharma-only treatment?
Perhaps clinical trials to bridge the preclinical-clinical gap may help.
If pharma won’t fund non-profitable studies, who will?
🔗 https://t.co/Xl4MxbjX2p

[Yakup Ergün @dr_yakupergun]

Ask any breast oncologist today, and they’ll tell you they prefer anthracycline-free regimens in HER2-positive breast cancer — and that anthracyclines don’t improve response rates.
So how did we accept a control arm containing anthracyclines in the DESTINY-Breast11 trial, which began in October 2021?

We can’t simply call this a sponsor-driven choice.
It’s the physicians who persuade patients to enroll — physicians who also receive payment for every screening and treatment visit.

Let’s be honest: how do you justify to your patients a control arm that doesn’t reflect your own real-world practice?

I’m open to any kind of criticism; just don’t come to me with the fairytale that anthracycline-containing arms are still the “standard.”

I know this sounds a bit harsh, but we’re exhausted from having to point out flaws in control arms every time new trial results are presented. We’re now seeing control arms that no longer represent today’s standards — some even belong to history (eg. ARANOTE trial).
It’s a call to all of us, as physicians, to think more carefully about the trials we support — if our genuine goal is the health and well-being of every patient, including those in the control arm.

[METUPUK @METUPUKorg]

#BreastCancerAwarenessMonth reminds the world to pay attention, but for those living with Metastatic Breast Cancer, every month is awareness month. There’s no pause. No relief. And we refuse to be invisible.

We are not a hidden corner of the community - we are over 60,000 strong in the UK. Our voices matter.

This October join the Fabric of Our Lives campaign. Help us hold the fabric together - with visibility, support, and change.

#FabricOfOurLives #BCAM25
#BreastCancerAwarenessMonth #BCAM  #SeverityModifier #METUPUK #DarkerPink #BusyLivingWithMets #IAmThe31 #waitingroomfeet #BreastCancer #BreastCancerCommunity #BreastCancerJourney #BreastCancerSupport #DyingForACure #EarlyDetectionSavesLives #MetastaticBreastCancerAwareness #SecondaryBreastCancer #SecondarySisters  #Stage4NeedsMore #StageIVNeedsMore #AdvancedBreastCancer

[Sara Tolaney @stolaney1]

Very big news out today-- adjuvant abemaciclib improves overall survival in high-risk ER+ breast cancer at ~7 yrs of f/u! Showing OS benefit in this setting is not easy & nice to see what an incredible impact adj cdk4/6i can have for our patients!

https://t.co/pxI4RxPxXz

[Kirstin Spencer @kjscello]

@dradityabardia @vinaykjain17 @DAVAOnc @breastoncdoc @minasedrakmd Encouraging - one person thought so much… his brain disappeared 😅
I hope patient advocates were integrated here. The state drugs leave our disease in must not be overlooked, it is a huge concern. The side effect of a being left with a much more aggressive disease is not okay.

[Kirstin Spencer @kjscello]

In California this week for @NBCC’s Project LEAD—an intensive training in breast cancer science, clinical trials & advocacy. Grateful for the scholarship & excited to deepen my impact for patients everywhere. #ProjectLEAD #BreastCancerAdvocacy #NBCC #METUPUK

[Dr. Kelly Shanahan @stage4kelly]

@christeeny513 also addresses patient concerns about brain biopsy - especially after attending an earlier session which presented data that biopsy or surgery of a brain met increases the risk of LMD. And kudos to @nlinmd for getting the patient perspective 1st! #ESMOBreast25

[Dr. Kelly Shanahan @stage4kelly]

In talking about whole brain radiation in MBC brain mets @christeeny513 reminds the panel and audience that WBR, in addition to causing cognitive deficits, also has the “side effect” of excluding people from virtually all clinical trials. #ESMOBreast25

[Dr. Kelly Shanahan @stage4kelly]

Not forgetting those who are triple positive, adding ET and a CDK4/6 to HER2 targeted therapy provides benefit over just antiHER2 + ET.

[Dr. Kelly Shanahan @stage4kelly]

Nick Turner sums up what we learned here about MBC, starting with EMBER3 #ESMOBreast25

[Elvina Almuradova @Dr_ElvinaA]

🔹 1L: AI or Fulv + CDK4/6i
🔹 2L:
 • PI3K & ESR1 wt: Fulv + Everolimus / Abemaciclib
 • ESR1 mut: Elacestrant
 • PI3K mut: Fulv + Alpelisib / Capivasertib
🔹 3L+: Options incl. chemo, Elacestrant, Olaparib, T-DXd
🔹 4L+: SG, DATO-DXd, biomarkers
@stolaney1 @oncodaily @myESMO

[Matteo Lambertini, MD PhD @matteolambe]

Proffered paper session at #ESMOBreast25 with @Prof_Nadia_H presenting the first results of #ADAPTcycle trial showing preliminary evidence on the possibility to avoid #chemotherapy by using CDK4/6i + endocrine therapy in early #BreastCancer @myESMO #ESMOAmbassadors @OncoAlert