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Thematic take on ASCO breast cancer abstracts: 1. Move 'em up. DB09, ASCENT-04, SERENA-6 are really just trials of using agents earlier in the course of advanced disease. Since all patients with the right tumor subtype will eventually get the agent, the only real question is:

DB09, ASCENT-04, SERENA-6 are shifting the treatment timeline -> bringing potent therapies to the front line. The question: Does earlier intervention translate to truly better outcomes? #ASCO25 #bcsm

Cowabunga! Riding Breast Cancer's Biggest Data's Wave 🏄🏻‍♂️🌊🤙🏻from ASCO25 WinPro trial: Adding prometrium to letrozole in ER+ breast cancer shows NO efficacy (88% vs 89% Ki67 suppression, p=0.4) but ↓ hot flushes (13% vs 22%). TAM +prometrium inferior at 62% 🌡️ OncoAlert #ASCO25

Dose escalation just makes sense and perhaps we should change how we dose all oral targeted meds

#ASCO25. Eleonora Teplinsky, MD highlights from phase 3 SERENA-6 trial that found switching to tx w camizestrant if an ESR1 mutation is detected during first-line treatment can help slow cancer growth for people w HR-positive, HER2-negative advanced #breastcancer: brnw.ch/21wT4Qq

This discussion of SERENA-6 trial was excellent. #ASCO25 This doesn’t feel practice changing to me.

Great data of db09 presented by Sara Tolaney #ASCO2025 however t of hp was only given for 6 mo whereas tdxd was given to disease progression, still 2 ild deaths, low number of >65yo and only 10% of thp went on to receive tdxd. However 15% cr begs the question of cure…… #bcsm

Indefinite T-DXd in 1L when patients could otherwise consider maintenance therapies and a chemo free interval is a hard sale. Great review of limitations and needed biomarkers, ongoing trials and overall intention in this patient population by Claudine Isaacs .

Agree! Also if we think in real world for our pts - maintenance HP (esp now we have a subq option) allow pts to not need a port, less frequent labs, less time spent in infusion, more time outside of cancer center Looking forward to hearing pt perspectives! GRASP ASCO

Next up #OntheClock ⏱️ with Dr Yan Leyfman of @mednewsweek at ASCO #ASCO25 is Laila Agrawal, MD of Norton Healthcare, who highlights a session focused on sexual concerns among cancer survivors. Did she beat the clock? 👀

#SOFT and #TEXT looking at AI vs. tam and OFS vs. not, 15 yr f/u 📌Adding OFS gives you 3.7% ⬆️ DFS 📌OFS + AI gets you 6.5% ⬆️ DFS 📍OFS + AI improves gives you ⬆️ 4.3% OS 🌟 Ultra young <35, it's even more important #ASCO25 #bcsm

Oral abstract session at #ASCO25 with 15-y follow-up data from ETOP IBCSG Partners Foundation SOFT & TEXT trials…proper risk stratification is needed to optimize adjuvant endocrine therapy in premenopausal women with #BreastCancer OncoAlert

A mini-thread for all of SOFT/TEXT 15 year update #ASCO25 1/2

One more NEJM paper for the #BreastCancer community at #ASCO25: very important data with use of #elinzanetant to help patients struggling with vasomotor symptoms during endocrine therapy OncoAlert

Even HP was not tolerable for me as maintenance treatment for HER2+ MBC. The patient community calls Perjeta “poo-jeta” for a reason! Indefinite T-DxD is not realistic- survivors will have to contend with long term SEs of ADCs (think ❤️& liver fx) #ASCO25 #bcsm

After recurrence, the median duration of first-line metastatic treatment was 3.0 months (IQR 1.6-5.0 months)…we need to identify best systemic therapy options for those recurring on adjuvant CDK4/6i!

🚨 NEW SURVEY ALERT! 🚨 Calling all oncology fellows (medical 💊, breast surgical 🔪, gynecology-onc, radiation onc ☢️)! forms.gle/XHGLfdTJFeVT7e…