Walter Weber, MD, on Implant-Based Breast Reconstruction Techniques After Mastectomy
Walter Weber, MD, of University Hospital Basel, presents data from the international randomized phase III PREPEC trial (OPBC-02), which found prepectoral implant-based breast reconstruction (IBBR) significantly and relevantly improved long-term quality of life—at the cost of a higher risk of loss or replacement of expander or implant—compared to subpectoral IBBR (Abstract 504).
Erika P. Hamilton, MD, FASCO, on HER2-Positive Metastatic Breast Cancer: Maintenance Therapy Comparison
Erika P. Hamilton, MD, FASCO, of Sarah Cannon Research Institute, talks about a comparison of the efficacy and safety of tucatinib vs placebo combined with trastuzumab and pertuzumab as maintenance therapy for HER2-positive metastatic breast cancer by stratified subgroups (Abstract 1005).
Yashasvini Sampathkumar, MD, on Job Retention Intervention for Patients Undergoing Breast Cancer Therapy: Digital vs Print Format
Yashasvini Sampathkumar, MD, of Memorial Sloan Kettering Cancer Center, presents data on Talking to Employers and Medical Staff about Work (TEAMWork), an English/Spanish intervention. The English/Spanish intervention, delivered as a booklet or mobile app, was developed to improve work outcomes among women undergoing breast cancer therapy. Dr. Sampathkumar discusses whether the digital vs print format was preferable among this population (Abstract 11060).
Robert C. Stein, PhD, MBBChir, FRCP, on ER-Positive HER2-Negative Early Breast Cancer: Test-Directed Chemotherapy
Robert C. Stein, PhD, MBBChir, FRCP, of the National Institute for Health Research University College London Hospitals Biomedical Research Centre, discusses the first results from the phase III randomized OPTIMA trial, which is comparing chemotherapy decisions made with the Prosigna (PAM50) gene expression test with standard treatment with estrogen receptor (ER)-positive, HER2-negative early breast cancer (Abstract 500).
Kevin Kalinsky, MD, MS, FASCO, on Metastatic Triple-Negative Breast Cancer: More Results From ASCENT-04
Kevin Kalinsky, MD, MS, FASCO, of Winship Cancer Institute of Emory University, provides an update focusing on progression-free survival after next line of treatment and subsequent therapies among patients enrolled in the ASCENT-04 trial. The study compared sacituzumab govitecan plus pembrolizumab vs chemotherapy plus pembrolizumab in patients with previously untreated PD-L1–positive metastatic triple-negative breast cancer (Abstract LBA1000).
Nicholas C. Turner, MD, PhD, on ER-Positive, HER2-Negative Advanced Breast Cancer: persevERA BC Trial
Nicholas C. Turner, MD, PhD, of the Royal Marsden Hospital, Institute of Cancer Research, discusses results from the primary analysis of the persevERA BC trial, which investigated giredestrant plus palbociclib vs letrozole plus palbociclib as first-line therapy in patients with estrogen receptor (ER)-positive, HER2-negative locally advanced or metastatic breast cancer (Abstract LBA1006).
Jana de Boniface, MD, PhD, on Breast Cancer With Sentinel Lymph Node Macrometastases: Can Axillary Dissection Be Omitted?
Jana de Boniface, MD, PhD, of Capio Saint Göran's Hospital and Karolinska Institutet, reviews overall survival and patient-reported arm morbidity findings from the SENOMAC trial, which sought to determine if patients with breast cancer and sentinel lymph node macrometastases could omit complete axillary dissection (Abstract LBA503).
Peter Schmid, MD, PhD, FRCP, on ER-Positive HER2-Negative Early Breast Cancer: Giredestrant by Menopausal Status
Peter Schmid, MD, PhD, FRCP, of Queen Mary University of London, shares more data from the phase III lidERA BC clinical trial. This analysis focused on the efficacy and safety of giredestrant in patients with estrogen receptor (ER)-positive, HER2-negative early breast cancer, looking at both premenopausal and postmenopausal populations (Abstract 502).
Siddhartha Yadav, MBBS, MD, on Germline Pathogenic Variants Among Patients With Breast or Ovarian Cancer
Siddhartha Yadav, MBBS, MD, of Mayo Clinic Rochester, talks about a real-world evaluation of germline pathogenic variants in cancer predisposition genes in unselected South Asian women with breast or ovarian cancer (Abstract 10513).
Martine J. Piccart-Gebhart, MD, PhD, on Personalizing Treatments in HR-Positive/HER2-Negative Breast Cancer
Martine J. Piccart-Gebhart, MD, PhD, of Jules Bordet Institute, Université Libre de Bruxelles, reviews multiple abstracts discussing avenues of personalized treatment for patients with hormone receptor (HR)-positive, HER2-negative breast cancer, including genomic testing and systemic therapy.
Sara A. Hurvitz, MD, FACP, on Metastatic Triple-Negative Breast Cancer: More Results From ASCENT-03
Sara A. Hurvitz, MD, FACP, of Fred Hutchinson Cancer Center, provides an update focusing on progression-free survival after next line of treatment and subsequent therapies among patients enrolled in the ASCENT-03 trial. The study compared sacituzumab govitecan vs chemotherapy in patients with previously untreated metastatic triple-negative breast cancer (Abstract 1001).
Case 3: Managing Toxicity to Maintain Long-Term Benefit
This is Part 3 of Shared Decisions, Better Outcome: Collaboration in Managing Targeted Therapy for HR-Positive/HER2-Negative Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Erika Hamilton, MD, Melissa Rikal, MSN, FNP-BC, AOCNP®, and Heather Moore, CPP, PharmD, discuss collaborative strategies for managing capivasertib toxicities in breast cancer. The patient is a 67-year-old woman with de novo hormone receptor–positive, HER2-negative metastatic breast cancer whose disease progressed on letrozole plus ribociclib and was found to have a PIK3CA mutation on next-generation sequencing. Notable comorbidities include diet-controlled type 2 diabetes, chronic kidney disease, GERD, and a prior history of eczema. The faculty highlight proactive strategies to lessen the impact of toxicities, including the use of metformin or SGLT2 inhibitors to mitigate hyperglycemia and prophylactic antihistimines or topical steroids to help manage rashes. They also address how comorbidities such as chronic kidney disease influence antihyperglycemic drug selection, the importance of drug interaction awareness, grading toxicities by body surface area involvement, and the careful sequencing of holds and dose reductions to keep patients on effective therapy long-term.
Case 2: Promoting Adherence Through Early Management Strategies
This is Part 2 of Shared Decisions, Better Outcome: Collaboration in Managing Targeted Therapy for HR-Positive/HER2-Negative Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Erika Hamilton, MD, Melissa Rikal, MSN, FNP-BC, AOCNP®, and Heather Moore, CPP, PharmD, discuss multidisciplinary strategies for managing targeted therapy in hormone receptor-positive breast cancer. The patient is a 62-year-old woman with strongly ER/PR-positive, HER2-negative invasive lobular carcinoma who was initially treated with curative intent but later develops metastatic disease with diffuse bone involvement. She has a history of prior aromatase inhibitor intolerance and multiple comorbidities including prediabetes, anorexia, and opioid-related gastrointestinal symptoms. The faculty emphasize proactive toxicity management, patient education, and frequent monitoring to improve adherence, underscoring how effective communication regarding potential side effects and dose reductions ensures long-term treatment success. The discussion highlights prophylactic strategies for key adverse events such as hyperglycemia, rash, diarrhea, and neutropenia, as well as the importance of multidisciplinary support.
Case 1: Treatment Considerations at Disease Progression on CDKi
This is Part 1 of Shared Decisions, Better Outcome: Collaboration in Managing Targeted Therapy for HR-Positive/HER2-Negative Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Erika Hamilton, MD, Melissa Rikal, MSN, FNP-BC, AOCNP®, and Heather Moore, CPP, PharmD, discuss team-based management of hormone receptor–positive metastatic breast cancer. The patient is a 44-year-old woman with de novo ER/PR-positive, HER2-negative metastatic breast cancer involving the liver, lymph nodes, and bone, who received ovarian suppression and ultimately a bilateral salpingo-oophorectomy prior to presenting with disease progression after 5 years of endocrine therapy plus a CDK4/6 inhibitor. The faculty highlight the importance of mutational testing to identify ESR1 mutations for selecting targeted therapies and explore oral options like elacestrant, imlunestrant, and vepdegestrant, emphasizing patient education for managing side effects. The panel also reviews team-based strategies for patient monitoring, counseling on tolerability, and considerations such as drug interactions and lipid monitoring when initiating therapy.
Joseph A. Sparano, MD, on Multimodal AI Models for Predicting Breast Cancer Recurrence
Joseph A. Sparano, MD, of the Icahn School of Medicine at Mount Sinai, discusses the performance of experimental multimodal artificial intelligence (AI) models integrating clinical, molecular, and histopathologic features to provide prognostic information for early and late recurrence using primary tumor samples and clinical data from participants in the TAILORx trial (Abstract GS1-08).
Jame Abraham, MD, FACP, on HER2-Positive Metastatic Breast Cancer: Choosing a Regimen in Clinical Practice
Jame Abraham, MD, FACP, puts findings from several trials in HER2-positive breast cancer into context, including HER2CLIMB, which investigated tucatinib, trastuzumab, and capecitabine in pretreated patients with metastatic disease; DESTINY Breast-09, which evaluated fam-trastuzumab deruxtecan-nki (T-DXd) plus pertuzumab in patients with advanced or metastatic disease who had received no previous chemotherapy or HER2-directed therapy for metastatic disease; and PATINA, which looked at the addition of palbociclib to maintenance anti-HER2 and endocrine therapies in hormone receptor–positive disease. Dr. Abraham is Enterprise Chair of the Department of Hematology & Medical Oncology at Cleveland Clinic and a Professor of Medicine at the Cleveland Clinic Lerner College of Medicine.
Jame Abraham, MD, FACP, on T-DXd in HER2-Positive Early Breast Cancer: Follow-up Data
Jame Abraham, MD, FACP, discusses follow-up data from the DESTINY Breast-05 and DESTINY Breast-11 trials of fam-trastuzumab deruxtecan-nki (T-DXd) for HER2-positive early breast cancer. DESTINY Breast-05 examined the agent given postneoadjuvantly, while DESTINY Breast-11 evaluated the agent in a neoadjuvant setting. Dr. Abraham is Enterprise Chair of the Department of Hematology & Medical Oncology at Cleveland Clinic and a Professor of Medicine at the Cleveland Clinic Lerner College of Medicine.
Jame Abraham, MD, FACP, on a Novel Oral SERD for ER-Positive, HER2-Negative Early Breast Cancer
Jame Abraham, MD, FACP, discusses the global, randomized lidERA Breast Cancer trial. Results from lidERA position giredestrant as a potential new standard of care for patients with estrogen receptor (ER)-positive, HER2-negative stage I to III early breast cancer, marking the first phase III trial to demonstrate a benefit with an oral selective estrogen receptor degrader (SERD) in this setting. Dr. Abraham is Enterprise Chair of the Department of Hematology & Medical Oncology at Cleveland Clinic and a Professor of Medicine at the Cleveland Clinic Lerner College of Medicine.
Case 3: Metastatic HR-Positive/HER2-Negative Breast Cancer With PTEN Loss and Emergent ESR1 Mutation
This is Part 3 of Balancing Benefit and Burden: Managing Toxicities in HR-Positive/HER2-Negative Metastatic Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Neil Iyengar, Sara Tolaney, and William Gradishar discuss the treatment of a patient with metastatic hormone receptor–positive/HER2-negative breast cancer with PTEN loss and emergent ESR1 mutation. The patient is a 61-year-old woman with a history of primary HR-positive/HER2-negative invasive lobular carcinoma who presents 7 years post-treatment with metastatic disease involving bone and colon. Her treatment course is complicated by baseline gastrointestinal symptoms from colonic involvement, and her baseline IBS-like symptoms require careful consideration when selecting therapies, particularly those with gastrointestinal toxicity profiles. In the conversation that follows, the faculty emphasize the superiority of FES PET for lobular carcinoma imaging and the importance of integrating multiple monitoring tools in bone-predominant disease. They highlight the role of serial molecular profiling to identify emergent alterations like ESR1 mutations and PTEN loss that create new therapeutic opportunities. The case underscores the importance of selecting treatments that balance efficacy against patient-specific tolerability factors.
Case 2: De Novo Metastatic PIK3CA-Altered HR-Positive/HER2-Negative Breast Cancer and Non–Insulin-Dependent Diabetes
This is Part 2 of Balancing Benefit and Burden: Managing Toxicities in HR-Positive/HER2-Negative Metastatic Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Neil Iyengar, Sara Tolaney, and William Gradishar discuss the treatment of a patient with PIK3CA-altered hormone receptor (HR)-positive/HER2-negative metastatic breast cancer and non–insulin-dependent diabetes. The patient is a 58-year-old postmenopausal woman presenting with de novo metastatic HR-positive/HER2-negative breast cancer involving the lungs and liver. Next-generation sequencing reveals a PIK3CA E542K mutation. She has a high-risk metabolic profile including pre-existing diabetes and obesity, and she was already receiving metformin therapy. As her disease progresses, she experiences severe hyperglycemia and a concurrent urinary tract infection. Patients with high-risk metabolic features require early endocrinology involvement and heightened vigilance when initiating PI3K pathway inhibitors. The faculty discuss the optimal treatment sequencing for this patient, the importance of risk stratification, prophylactic strategies such as metformin optimization and early SGLT2 inhibitor use, and the crucial role of intensive glucose monitoring for high-risk patients.
Case 1: PIK3CA-Altered HR-Positive/HER2-Negative Metastatic Breast Cancer
This is Part 1 of Balancing Benefit and Burden: Managing Toxicities in HR-Positive/HER2-Negative Metastatic Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Neil Iyengar, Sara Tolaney, and William Gradishar discuss the treatment of a patient with PIK3CA-altered hormone receptor (HR)-positive/HER2-negative metastatic breast cancer. The patient is a 64-year-old postmenopausal woman with a history of early-stage HR-positive/HER2-negative breast cancer that was originally treated with lumpectomy, chemotherapy, radiation, and 10 years of endocrine therapy. Two years post-treatment, she presents with metastatic disease to her bone and liver, and next-generation sequencing reveals a PIK3CA H1047R mutation. As her disease progresses, the patient requires glucose monitoring and management due to capivasertib-associated hyperglycemia. In the conversation that follows, the faculty review treatment options for patients with PIK3CA-altered disease, the role of early genomic testing, and the nuances of AKT vs PI3K inhibitor selection. They emphasize the importance of proactive toxicity management for high-risk patients, including glucometer education for hyperglycemia and multidisciplinary collaboration to ensure that patients are able to continue treatment.
Case 3: Cardiac Risk Stratification
This is Part 3 of Managing Cardiovascular Risk in Metastatic Breast Cancer: Clinical Insights on CDK4/6 Inhibitors, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Kelly McCann, Hope Rugo, and Avirup Guha discuss a challenging patient case: a 76-year-old woman with metastatic estrogen receptor–positive, HER2-negative breast cancer who presents with chest pain, dyspnea, and new-onset atrial fibrillation with rapid ventricular response. The patient has significant cardiovascular risks, including a history of heavy smoking, high BMI, and a general avoidance of doctors. In the conversation that follows, Dr. Guha outlines the essential cardiac work-up, emphasizing immediate stabilization and highlighting the importance of patient education and addressing social determinants of health as crucial outpatient follow-up strategies. Dr. Rugo discusses managing effusions and recommends palbociclib as the preferred CDK4/6 inhibitor for this patient, given her cardiac issues. The panel concludes that comprehensive cardiovascular risk assessment is essential for these patients, whose prognosis is often measured in years, making optimization of cardiovascular health vital for their quality and quantity of life.
Case 2: CDK4/6 Inhibitor Choice in Medically Fragile Patients With Heart Failure
This is Part 2 of Managing Cardiovascular Risk in Metastatic Breast Cancer: Clinical Insights on CDK4/6 Inhibitors, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Kelly McCann, Hope Rugo, and Avirup Guha discuss managing cardiovascular risk for a 41-year-old premenopausal woman with complex congenital heart disease, heart failure, and metastatic estrogen receptor–positive, HER2-negative breast cancer. The patient’s extensive medical history makes CDK4/6 inhibitor choice challenging. In the conversation that follows, the experts emphasize a team-based approach involving oncologists, cardiologists, and pharmacists for fragile patients. They outline workup strategies for worsening dyspnea, including ruling out progressive disease, pulmonary embolism, and pneumonitis, and performing cardiac exams and rhythm monitoring. Cardio-oncology can help manage CDK4/6 inhibitor–related toxicities, such as severe diarrhea, to enable cancer treatment while mitigating cardiovascular risks. Close collaboration is essential, as these therapies can exacerbate existing cardiovascular issues like fluid shifts, electrolyte imbalances, and increased venous thrombosis risk.
Case 1: Management of Cardiovascular Risk Factors
This is Part 1 of Managing Cardiovascular Risk in Metastatic Breast Cancer: Clinical Insights on CDK4/6 Inhibitors, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Kelly McCann, Hope Rugo, and Avirup Guha discuss cardiovascular risk management in a 47-year-old patient with metastatic estrogen receptor–positive/HER2-negative breast cancer. After prior anthracycline exposure and estrogen-deprivation therapy (EDT), the patient developed cardiovascular risk factors including hypertension and borderline diabetes. EDT can worsen cardiovascular health by affecting lipid profiles, insulin resistance, and blood pressure, potentially leading to a prothrombotic state. In the conversation that follows, the panel highlights the oncologist’s crucial role in proactively co-managing cardiovascular risks with cardiologists and primary care, stressing the importance of communication between providers. They also provide key insights in monitoring QTc prolongation, a side effect of ribociclib. Guidelines for management include baseline/regular ECG checks, electrolyte correction, and dose adjustments or permanent discontinuation for significant prolongation.
Erika Hamilton, MD, on Oral SERDs in Breast Cancer: State of the Science
Erika Hamilton, MD, Director, Breast Cancer Research at Sarah Cannon Research Institute, provides a look at “where we stand in 2025” in the field of oral selective estrogen receptor degraders (SERDs) for patients with estrogen receptor–positive, HER2-negative breast cancer. She discusses the first and only FDA-approved oral SERD, elacestrant, indicated for use after CDK4/6 inhibitor therapy in patients with ESR1 mutations; reviews agents still being tested in clinical trials, such as imlunestrant and camizestrant; and highlights the role of oral SERDs as both monotherapies and in novel combinations. As Dr. Hamilton explains, “there haven’t been novel endocrine backbones [for these patients] since fulvestrant.”
Case 1: First-Line Treatment of HR-Positive, HER2-Negative Metastatic Breast Cancer With ESR1 Y537S Mutation
This is Part 1 of The Role of Oral SERDs in Metastatic Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Komal Jhaveri, Erika Hamilton, and Aditya Bardia discuss the treatment of a 61-year-old female patient who presents with bone pain 18 months after completion of adjuvant aromatase inhibitor therapy for an enlarged, suspicious axillary lymph node. A computed tomography scan shows numerous liver and bone metastases, and a liver biopsy confirms estrogen receptor–positive, progesterone receptor–negative, HER2-negative carcinoma consistent with breast primary. Circulating tumor DNA testing reveals an ESR1 Y537S mutation, and she has no BRCA1/2 mutations. The patient has a history of ventricular tachycardia and bipolar disorder, both controlled with medications known to cause QTc prolongation. In the conversation that follows, the faculty review first-line treatment options for this patient with ESR1 Y537S–mutated metastatic breast cancer, including selective estrogen receptor degraders (SERDs) both alone and in combination with CDK4/6 inhibitors, as well as the impact of her comorbidities on treatment selection. They also review the recent results of SERENA-6 and discuss whether they would be applicable to this patient.
Case 3: Leptomeningeal Disease in HER2-Positive Breast Cancer
This is Part 3 of Novel Therapies for HER2-Positive Breast Cancer Brain Metastases, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Carey Anders, Rani Bansal, and Sarah Sammons discuss the treatment of a patient with a history of ER/PR-negative, HER2-positive de novo metastatic breast cancer to the liver and brain. The 39-year-old patient initially responded well to systemic therapy and localized brain treatments but later developed symptomatic HER2-positive leptomeningeal disease (LMD), confirmed by brain MRI and lumbar puncture. In the conversation that follows, the faculty review effective systemic therapies like trastuzumab deruxtecan and the HER2CLIMB regimen of tucatinib, capecitabine, and trastuzumab. They discuss current approaches to LMD, including radiation therapy (with considerations for proton-based strategies to preserve cognitive function) and emphasize the crucial role of early palliative care for symptom management and support when dealing with LMD.
Case 1: Isolated Brain Relapse in HER2-Positive Breast Cancer
This is Part 1 of Novel Therapies for HER2-Positive Breast Cancer Brain Metastases, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Carey Anders, Rani Bansal, and Sarah Sammons discuss the treatment of a patient with a cT2N1, grade 3, ER/PR/HER2-positive invasive ductal carcinoma. The 35-year-old female patient is premenopausal and achieved a pathologic complete response (pCR) after standard neoadjuvant chemotherapy, lumpectomy, and radiation. She began 1 year of ovarian suppression, aromatase inhibitor, and trastuzumab plus pertuzumab, but in the final month of her adjuvant treatment, she developed dizziness and nausea. Despite pCR, patients with HER2-positive localized breast cancer face a higher risk of intracranial recurrence (approximately 10%–12%), often without extracranial disease. In the conversation that follows, the faculty review treatment considerations for this patient—including when to consider neurosurgical resection, focused radiation therapy, or other systemic therapies—and discuss ongoing trials seeking to potentially prevent intracranial recurrence in patients with residual disease, such as CompassHER2 RD.
Erika Hamilton, MD, on ER-Positive HER2-Negative Advanced Breast Cancer: Vepdegestrant vs Fulvestrant
Erika Hamilton, MD, Director, Breast Cancer Research at Sarah Cannon Research Institute, reviews data from the global, randomized, phase III VERITAC-2 study, which compared vepdegestrant, an oral PROTAC (PROteolysis TArgeting Chimera) estrogen receptor degrader, to fulvestrant among patients with ER-positive HER2-negative advanced breast cancer. Vepdegestrant is the first PROTAC to be evaluated in a phase III trial (Abstract LBA1000).
Hope S. Rugo, MD, FASCO, and Rebecca Alexandra Dent, MD, FASCO, on Breast Cancer Data Highlights: Sequencing of Endocrine Therapy
Hope S. Rugo, MD, FASCO, of City of Hope, and Rebecca Alexandra Dent, MD, FASCO, of National Cancer Centre Singapore, review the results of a biomarker analysis of the DESTINY-Breast06 trial, which evaluated trastuzumab deruxtecan after endocrine therapy in patients with metastatic breast cancer (Abstract 1013). They also discuss findings from the SERENA-6 and EMBER-3 trials, also presented at ASCO 2025, and what all this new data means for the sequencing of endocrine therapy in patients with breast cancer.
Neil M. Iyengar, MD, on Cancer Risk Reduction: Effects of Menopausal HRT and GLP-1 RAs
Neil M. Iyengar, MD, of Memorial Sloan Kettering Cancer Center, reviews several studies that aimed to answer two questions: does menopausal hormone therapy (HRT) impact overall survival and breast cancer–specific mortality in younger women diagnosed with high-risk disease (Abstract 10506); and do GLP-1 receptor agonists (GLP-1 RAs), a class of weight-loss medications, have cancer risk reduction properties (Abstracts 10507 and 10508).
Stephen K.L. Chia, MD, FRCPC, on Advanced HER2-Negative and ER-Positive Breast Cancer: SERD and AKT Inhibitor
Stephen K.L. Chia, MD, FRCPC, of BC Cancer Agency, reviews data from the phase III CCTG/BCT MA.40/FINER trial of fulvestrant and ipatasertib for advanced HER2-negative, ER-positive breast cancer following disease progression on first-line CDK 4/6 and aromatase inhibitors (LBA1005).
Karen Eubanks Jackson on Receiving the 2025 ASCO Patient Advocate Award
Karen Eubanks Jackson, Founder and Chief Executive Officer of Sisters Network Inc. and recipient of the 2025 ASCO Patient Advocate Award, discusses her 30-year-long effort to support patients with breast cancer in the Black community. Sisters Network is focused on raising awareness of early screening for breast cancer, providing financial assistance, and addressing the disparities Black women face in breast cancer care and outcomes.
Sara M. Tolaney, MD, MPH, FASCO, on PD-L1–Positive Advanced TNBC: First-Line Doublet Comparison
Sara M. Tolaney, MD, MPH, FASCO, of Dana-Farber Cancer Institute and Harvard Medical School, discusses findings from the phase III ASCENT-04/KEYNOTE-D19 study, which compared sacituzumab govitecan-hziy plus pembrolizumab vs chemotherapy plus pembrolizumab in previously untreated patients with PD-L1–positive advanced triple-negative breast cancer (TNBC) (LBA109).
Mafalda Oliveira, MD, PhD, on How Does Hyperglycemia Affect Treatment of Advanced Breast Cancer?
Mafalda Oliveira, MD, PhD, of Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology, discusses findings on the incidence and management of hyperglycemia in a subset of patients with prediabetes and/or obesity included in the phase I trial of inavolisib alone and in combination with endocrine therapy with or without palbociclib for PIK3CA-mutated, hormone receptor–positive, HER2-negative locally advanced/metastatic breast cancer (Abstract 1004).
Nicholas C. Turner, MD, PhD, on Treating Emergent ESR1 Mutations in Advanced Breast Cancer
Nicholas C. Turner, MD, PhD, of the Royal Marsden Hospital, presents findings from the phase III, double-blind ctDNA-guided SERENA-6 trial, which evaluated the combination of camizestrant plus a CDK4/6 inhibitor to treat emergent ESR1 mutations during first-line endocrine therapy for patients with HR-positive, HER2-negative advanced breast cancer (LBA4).
Nicholas C. Turner, MD, PhD, on INAVO120: Final Overall Survival Analysis
Nicholas C. Turner, MD, PhD, of the Royal Marsden Hospital, presents final overall survival data from the INAVO120 trial of inavolisib/placebo plus palbociclib and fulvestrant in patients with PIK3CA-mutated, HR-positive, HER2-negative, endocrine-resistant advanced breast cancer (Abstract 1003).
Giuseppe Curigliano, MD, PhD, on Patient-Reported Outcomes From EMBER-3
Giuseppe Curigliano, MD, PhD, of Istituto Europeo di Oncologia, IRCCS, University of Milano, discusses patient-reported outcomes from the phase III EMBER-3 trial, which investigated treatment with imlunestrant, investigator’s choice of standard endocrine therapy, or imlunestrant plus abemaciclib in patients with ER-positive, HER2-negative advanced breast cancer (Abstract 1001).
Case 1: First-Line Therapy in HR-Positive Metastatic Breast Cancer
This is Part 1 of PI3K Inhibition Strategies for HR-Positive/HER2-Negative Metastatic Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Adam Brufsky, Heather McArthur, and Seth Wander discuss the first-line treatment of hormone receptor (HR)-positive metastatic breast cancer. The patient is a 64-year-old postmenopausal woman with a history of asymptomatic left bundle branch block and irritable bowel syndrome. In 2015, she was diagnosed with a 3.5-cm invasive ductal carcinoma of the left breast with 3 positive axillary lymph nodes. She was treated with dose-dense doxorubicin, cyclophosphamide, and paclitaxel and postmastectomy radiation therapy, and then received anastrozole for 5 years, completing therapy in 2021. In 2024, she complains of worsening back pain, and PET-CT scan reveals multiple lytic lesions of the thoracic and lumbar spine, as well as a 3-cm lesion in the liver. In the conversation that follows, the faculty discuss how the treatment of HR-positive breast cancer has changed over the past decade, the appropriate duration of adjuvant endocrine therapy, what blood or biomarker tests to perform, and how to choose between doublet and triplet therapy with PI3K inhibitors.
Case 3: Second-Line Therapy for HR-Positive/HER2-Positive Metastatic Breast Cancer
This is Part 3 of Evolving Paradigms in the Treatment of HR-Positive/HER2-Positive Metastatic Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Sara Tolaney, Ian Krop, and Mark Pegram discuss second-line therapy for hormone receptor (HR)-positive/HER2-positive metastatic breast cancer. The patient is a 62-year-old woman who received first-line paclitaxel plus trastuzumab for de novo metastatic HR-positive/HER2-positive breast cancer. After seven cycles, she stopped paclitaxel and initiated an aromatase inhibitor plus trastuzumab plus pertuzumab plus palbociclib. She remained on therapy for approximately 3 years and then developed new liver metastases and a single brain metastasis, for which she was asymptomatic. In the conversation that follows, the faculty discuss the role of screening brain MRIs for patients with metastatic HER2-positive breast cancer, local vs systemic treatment for brain metastases, and how to approach the timing of systemic therapy with radiation.
Case 2: Next Steps After First-Line Induction Therapy for HR-Positive/HER2-Positive Metastatic Breast Cancer
This is Part 2 of Evolving Paradigms in the Treatment of HR-Positive/HER2-Positive Metastatic Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Sara Tolaney, Ian Krop, and Mark Pegram discuss how to manage a patient following first-line induction therapy for metastatic hormone receptor (HR)-positive/HER2-positive breast cancer. The patient is a 62-year-old woman who had initiated therapy with weekly paclitaxel plus trastuzumab and pertuzumab for her de novo metastatic disease. She had resolution of her liver metastasis and reduction in her breast mass. After seven cycles of therapy, however, she began to experience worsening neuropathy. In the conversation that follows, the faculty discuss when to discontinue paclitaxel, clinical implications of the recently presented PATINA trial, whether palbociclib should be a standard addition to maintenance for all patients with HR-positive/HER2-positive metastatic breast cancer, and more.
Case 1: De Novo Metastatic HR-Positive/HER2-Positive Breast Cancer
This is Part 1 of Evolving Paradigms in the Treatment of HR-Positive/HER2-Positive Metastatic Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Sara Tolaney, Ian Krop, and Mark Pegram discuss the treatment of de novo metastatic hormone receptor (HR)-positive/HER2-positive breast cancer. The patient is a 62-year-old woman who presented with a palpable right breast mass and ipsilateral axillary lymph node. Biopsy confirmed the breast mass as a high-grade invasive ductal carcinoma that was strongly hormone receptor–positive and HER2 IHC 3+. Fine-needle aspiration of the axillary node was positive, and staging studies revealed a single liver metastasis consistent with her breast primary tumor. In the conversation that follows, the faculty discuss whether there is a role for surgery or locoregional therapy in patients with de novo metastatic HR-positive/HER2-positive disease, what systemic treatment options would be appropriate, and endocrine-based options for patients with contraindications to chemotherapy.
Andrew Tutt, MB ChB, PhD, FMedSci, on OlympiA: High-Risk BRCA-Positive Breast Cancer
Andrew Tutt, MB ChB, PhD, FMedSci, Director of The Breast Cancer Now Toby Robins Research Centre and the Institute of Cancer Research (ICR) and Guy’s Hospital King’s College, London, discusses longer-term follow-up of OlympiA, a phase III, multicenter, randomized, placebo-controlled trial of adjuvant olaparib after (neo)adjuvant chemotherapy in patients with germline BRCA1/BRCA2 pathogenic variants and high-risk HER2-negative primary breast cancer (Abstract GS1-09).
Nan Chen, MD, on Impact of Anthracyclines in High Genomic Risk Node-Negative HR-Positive/HER2-Negative Breast Cancer
Nan Chen, MD, of the University of Chicago Medicine, Chicago, discusses the impact of anthracyclines in high genomic risk node-negative HR-positive/HER2-negative breast cancer (Abstract GS3-03).
Kathryn Newlin, RN, MSN, ANP-BC, on Updates in HR-Positive, HER2-Negative Metastatic Breast Cancer
Kathryn Newlin, RN, MSN, ANP-BC, of Washington University in St. Louis, discusses her presentation on HR+ HER2- metastatic breast cancer from the JADPRO Live conference recently held in Grapevine, Texas. Kathryn covers factors involved in treatment selection for this patient population, including key agents in the armamentarium, relevant biomarkers and the emergence of HER2 low as a factor in added treatment options, and the management of adverse effects.
Adrienne Waks, MD, on MARGOT/TBCRC052: Phase II Trial in HER2-Positive Breast Cancer
Adrienne Waks, MD, of Dana-Farber Cancer Institute, Boston, discusses the randomized phase II trial comparing neoadjuvant paclitaxel/margetuximab/pertuzumab vs paclitaxel/trastuzumab/pertuzumab in patients with stage II-III HER2-positive breast cancer. This trial is being done to determine how well HER2-positive breast cancer responds to preoperative treatment using one of two different combinations of drugs as a treatment for this diagnosis (Abstract LB1-02).
Aditya Bardia, MD, on Destiny-Breast06: An Additional Analysis
Aditya Bardia, MD, of UCLA David Geffen School of Medicine, Los Angeles, presents the additional analysis of the efficacy and safety of trastuzumab deruxtecan vs physician’s choice of chemotherapy by pace of disease progression on prior endocrine-based therapy from DESTINY-Breast06 (Abstract LB1-04).
Mafalda Oliveira, MD, PhD, on Primary Results of SOLTI VALENTINE
Mafalda Oliveira, MD, PhD, of Vall d’Hebron Institute of Oncology, Spain, presented the primary results of SOLTI VALENTINE, a neoadjuvant randomized phase II trial of HER3-DXd alone or in combination with letrozole for high-risk hormone receptor–positive/HER2-negative early breast cancer (Abstract LB1-06).
Sibylle Loibl, MD, PhD, on Primary Results of the Randomized, Phase III PADMA Study in HER2-Negative/HR-Positive Metastatic Breast Cancer
Sibylle Loibl, MD, PhD, of the German Breast Group, Neu-Isenburg, Germany, presented primary results of the randomized phase III PADMA trial comparing first-line endocrine therapy plus palbociclib vs standard mono-chemotherapy in women with high-risk HER2-negative/HR-positive metastatic breast cancer and indication for chemotherapy (Abstract LB1-03).
Tiffany Traina, MD, FASCO, on Advances in the Treatment of HR-Positive Breast Cancer
Tiffany Traina, MD, FASCO, is Vice Chair of the Department of Medicine at Memorial Sloan Kettering Cancer Center, where she has been a medical oncologist on the Breast Medicine Service since 2006. Dr. Traina is also the Section Head of the Triple Negative Breast Cancer Clinical Research Program. In this video, Dr. Traina speaks with The ASCO Post about management options and advances in the treatment of HR-positive breast cancer. Dr. Traina was co-Program Chair of the recent Chemotherapy Foundation Symposium.
