Michele Bottosso

MD, Medical Oncologist, PhD Student #BreastCancer

[Prof. Dr. Ahmet Dirican @dr_dirican]

Most guidelines recommend brain imaging in HER2-positive metastatic breast cancer only when neurological symptoms appear.

Griguolo et al.: Annual proactive brain CT screening → fewer symptomatic brain metastases and better performance status.

But an important question remains:

In the era of new anti-HER2 therapies (T-DXd, tucatinib, etc.), will the natural history of brain metastases change — and will screening strategies still carry the same clinical value?

Results of the proactive annual brain CT screening study by Griguolo et al.:

* earlier detection of asymptomatic brain metastases
* fewer symptomatic presentations (0% vs 9.5%)
* better performance status at the time of brain metastasis diagnosis
@oncodaily @OncBrothers @PTarantinoMD @tompowles1 @Dr_Oncologista @myESMO @ASCOPost

https://t.co/Vo621alIbe

[Gaia Griguolo @GaiaGriguolo]

Our retrospective real-world study out @CCR_AACR

In HER2+ mBC proactive brain screening by CE CT scans (at least 1 scan per year)
associated with:
⬇️in symptomatic 🧠 mets diagnosed at 2 yrs (0% vs 9.5%)
⬆️KPS at 🧠 mets diagnosis

https://t.co/3Q0dnnDFm4
@OncoAlert @UniPadova

[Michele Bottosso @M_Bottosso]

Check out PS3-01-10 today at #SABCS25 on metastatic patterns in BRCA1/2 carriers:

🔹HR+: higher and earlier CNS involvement
🔹TNBC: fewer liver metastases, similar high CNS involvement

📍BRCA1/2 status may help tailor radiological surveillance

@vitti10 @GaiaGriguolo @massa12d

[Luca Arecco, MD @Lucarecco]

Do gBRCA PVs impact CDK4/6i efficacy in HR+/HER2– MBC?

This M-A in @TheBreastOnline included 16,884 pts (618 BRCA) and showed worse PFS & OS with CDK4/6i in BRCA:
➡️ HR for PFS: up to 2.0
➡️ HR for OS: up to 1.7
Resistance pathways: RB1 loss, ESR1, non-luminal BC.

@OncoAlert

[Gaia Griguolo @GaiaGriguolo]

Finally out @ESMO_Open!
Gene-expression of breast cancer brain metastases:
-high rate of non-luminal subtypes -shift towards HER2-enriched (primary vs 🧠 mts)
- high PAM50 basal-like sig associated with worse OS (overall and HR+/HER2- 🧠 mts)
@OncoAlert
https://t.co/IBuE9NFdKO

[Oscar Tahuahua @drtahuahua]

Gene expression profiling in breast cancer brain mets

Among matched pairs, 42% lost ER, 55% lost PR, 45% gained HER2 & 42% acquired a basal-like phenotype. BM showed ↓luminal markers & ↑immune genes, revealing molecular divergence from the primaries
https://t.co/wSC1OjO0ls

[Gaia Griguolo @GaiaGriguolo]

#ESMOBreast25
In eTNBC achieving pCR, TILs maintain prognostic value.
Low TILs and cN+ identify a subgroup of patients at worse prognosis despite pCR: space for escalation?

Great work by @DavideMass90094 @vitti10 from our group! Great international collaboration!
@OncoAlert

[Gaia Griguolo @GaiaGriguolo]

Multi-institutional study (779 pts with BC 🧠 mets over 22 years) shows:
🔹 Changes in RT (SRS ↑; WBRT ↓)
🔹 Increase in anti-HER2 tx
🔹 OS unchanged overall, but… improvement in HR-/HER2+ BC mOS 8.7 → 23.7 months (p=0.002)

https://t.co/k8lgyOk6uS
@OncoAlert @M_Bottosso

[Gaia Griguolo @GaiaGriguolo]

As we are all going back home from #SABCS24 , check out out spotlight poster on actionable alterations in breast cancer brain metastases if you missed it!
High rate of BRCA1/BRCA2/PALB2 alterations and of PIK3CA/PTEN alterations!
@OncoAlert

[Michele Bottosso @M_Bottosso]

❓ How can gene expression assays guide the choice of adjuvant endocrine therapy in #breastcancer?

👉🏻 Check out our review in @CCR_AACR

@GaiaGriguolo @vitti10 @FedeMiglietta
https://t.co/7toOfkVqwR

[Maria Vittoria Dieci @vitti10]

A lot of discussion these days around ER-low. We present data in >1200 MBC including prognosis, switch from primary tumor, TILs and data from the TONIC trial! Stop at poster board 78! #ASCO24 @FedeMiglietta @lab_kok

[Gaia Griguolo @GaiaGriguolo]

Check Poster 558 #ASCO24 !
- PAM 50 and TILs/immune signatures capture only partially overlapping information on HR+/HER 2 BC biology
Are pts with Basal-like HR+/HER 2 BC and high TILs r ideal candidates for neoadjuvant ICI+chemo?
#bcsm @vitti10 @OncoAlert @TILsWorkGroup

[Yakup Ergün @dr_yakupergun]

TP53-associated early breast cancer

227 pts, mFU: 70 mo

mAge➡️37
HR+/HER2-➡️40.9%
HR+/HER2+➡️34.4%

5y RFS (HR+/HER2)➡️61.1%!!
5y radiation-induced sarcoma➡️4.8%‼️

Quite an informative analysis. Congrats to all the researchers

@OncoAlert @JNCI_Now
https://t.co/9LJkcuNEwD

[Michele Bottosso @M_Bottosso]

Out in @ESMO_Open our review on precision medicine in #breastcancer:
📍milestones of genomics to predict drug sensitivity
📍new dimensions of cancer biology
📍future directions of precision medicine
@FerMosele @FAndreMD @StefanMichiels @GustaveRoussy
https://t.co/8GwpitSwfQ

[Maria Vittoria Dieci @vitti10]

ERlow = ERneg BC from molecular and immune perspective. Come to visit our poster P01-03-09. Find us in the “Triple Negative” poster row: a sign that times are finally mature for a change? @GaiaGriguolo @FedeMiglietta @UniPadova @iov_irccs #SABCS23 @OncoAlert

[Federica Miglietta @FedeMiglietta]

We are so glad to share our immuno-genomic model for HR+/HER2- eBC based on the integrated evaluation of Recurrence Score & TILs.
💡Just out on European Journal of Cancer
@vitti10
https://t.co/Ypua5M4XrE

[Federica Miglietta @FedeMiglietta]

At the INNOVATORS - after ESMO meeting, @M_Bottosso discusses on Li-Fraumeni sdr, firstly described here ⬇️ by Frederick Li and Joseph Fraumeni in 1969.
https://t.co/uLqPXq9h7f
@ALEDIGNUS12 @valeguarneri

[Gaia Griguolo @GaiaGriguolo]

In HR+HER2- early breast cancer, high genomic risk tumors by OncotypeDX present higher levels of TILs (more than 10%) ! -> potential clinical implications?
Great minioral presentation today by @FedeMiglietta of our group at #ESMO23 !
#bcsm @vitti10 @UniPadova @iov_irccs

[Gaia Griguolo @GaiaGriguolo]

🧠 Can we non invasively assess HER2 status of breast cancer brain metastases using radiomics? #bcsm #brainmets
Check out poster 479P at today's poster session at #ESMO2023 #ESMO23

@iov_irccs @UniPadova @vitti10 @OncoAlert

[Federica Miglietta @FedeMiglietta]

Finally out on @JCO_ASCO the 10-Year update of the ShortHER trial: proud and honored to be part of this relevant work
@vitti10

https://t.co/GcNuSebWua