#ASCO26
ER+, HER2- breast cancer management is becoming less about “one-size-fits-all” and more about precision escalation vs precision de-escalation.
The future is clear:
🧬 Biomarkers decide who gets chemo
💊 CDK4/6 inhibitors move earlier
🩺 Endocrine therapy intensifies in high-risk disease
⚖️ Obesity and supportive care become survival interventions
Key themes from ASCO 2026:
▪️ Anthracyclines may still matter in selected genomically high-risk patients
▪️ Some node+ patients may safely avoid chemotherapy
▪️ OFS + AI remains critical for high-risk premenopausal disease
▪️ Adjuvant abemaciclib and ribociclib continue reshaping standards
▪️ Oral SERDs are entering early breast cancer
▪️ Weight management may become part of oncologic care itself
Breast oncology is shifting from anatomy-driven to biology-driven treatment selection.
Which biomarker do you think will have the biggest impact in early ER+ breast cancer over the next 5 years? 👀
@OncoAlert@ASCO@myesmo@esmo_open@larvol
#OncoTwitter #MedTwitter #BreastCancer #bcsm #PrecisionOncology
Current approved treatment options for HR+, HER2− mBC
ESMO Guidelines: Real World Cases Webinar: Metastatic Breast Cancer 2026 presentation
https://t.co/H3S9DZXsK2
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What's inside ↓
ESMO Breast 2026 — key trials at a glance
• HER2+ trials
• HR+/HER2− trials
• TNBC / ADC / Immunotherapy trials
Major studies, key results, and clinical take-home messages — all in one quick visual summary.
#ESMOBreast2026#BreastCancer#Oncology#MVOnco
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HER2+ early breast cancer — can we omit chemotherapy?
PHERGain (5-year results):
• PET-guided strategy
• ~1/3 patients avoided chemotherapy
• Excellent outcomes in responders
Key takeaway:
👉 Response-adapted de-escalation is feasible in selected patients
⚠️ Phase II data
#BreastCancer #HER2 #Oncology #ESMOBreast2026 #MVOnco
Algorithm for Systemic Therapy in HER2-Positive Breast Cancer
(Based on NCCN and ESMO guidelines; recommendations in gray areas reflect the St. Gallen 2025 consensus and, in part, my own clinical judgment)
Here is Version 2.0 of when to hold systemic tx during RT. Updated & w 3 additional drug categories (ADCs, CDK4/6 inhibitors, PARPi).
More details on newer drugs in 🧵 below.
Please use this version as reference & thanks for all input/experience crowdsourcing! (1/3)