Armando Orlandi: Day 3 of ASCO25 – Key Breast Cancer Updates
Armando Orlandi, Medical Director at the Agostino Gemelli University Hospital Foundation IRCCS, posted on LinkedIn:
“Day 3: 06.01 – ASCO 2025 – Key Breast Cancer Updates – Clinical Insights.
Here are the clinically relevant takeaways:
PRECISION ONCOLOGY BREAKTHROUGH
SERENA-6represents a paradigm shift: liquid biopsy-guided switching to camizestrant upon ESR1 mutation emergence nearly doubled PFS (16.0 vs 9.2 months, HR 0.44). This moves us from reactive to predictive oncology.
Angela De Michele’s plenary discussion provided exceptional clinical context – her critical analysis of trial design and real-world applicability should be required reading for practicing oncologists.
TRIPLE-NEGATIVE BREAST CANCER UPDATES
NRG-BR003: Adding carboplatin to AC to paclitaxel failed to reach statistical significance (p=0.097) despite numerical improvement in IDFS (82.9% vs 77.8%). The toxicity-benefit ratio remains unfavorable.
ABCSG 45: HRD status alone insufficient for treatment selection. Olaparib/carboplatin achieved 77% pCR in BRCA+ patients but only 21% in BRCA-WT (vs 57% with standard TAC). BRCA mutation status remains the key biomarker.
NeoSTAR: First combination trial of sacituzumab govitecan + pembrolizumab showed 34% pCR – promising but requiring optimization of sequencing with standard chemotherapy.
CDK4/6 INHIBITOR LANDSCAPE EVOLVES
DAWNA-A: Dalpiciclib demonstrated 44% risk reduction (HR 0.56, p<0.0001) in adjuvant setting, though 20-month follow-up requires longer confirmation.
NATALEE subanalysis: Ribociclib benefits consistent across all ages and menopausal status. Notably, younger premenopausal patients showed superior tolerability (10.5% vs 27.9% discontinuation in older patients).
TRADE: Game-changing dose escalation strategy for abemaciclib (50→100→150mg) achieved 71% target dose maintenance vs historical monarchE data, with only 3.4% toxicity-related discontinuation.
ADDITIONAL INSIGHTS
PROMISE: CE/BZA significantly reduced Ki-67 in ER+ DCIS (-5.6% vs -1.1%, p=0.016) without quality of life impact.
SHARE: RT APBI showed mixed toxicity profile vs WBI – reduced skin toxicity (HR 0.55) but increased breast fibrosis (HR 2.06) and rib fractures.
CLINICAL IMPLICATIONS
These data reinforce that precision medicine in breast cancer requires biomarker-driven decisions, optimal drug sequencing, and individualized toxicity management strategies.”
More posts featuring ASCO25.
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Challenging the Status Quo in Colorectal Cancer 2024
December 6-8, 2024
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ESMO 2024 Congress
September 13-17, 2024
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ASCO Annual Meeting
May 30 - June 4, 2024
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Yvonne Award 2024
May 31, 2024
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OncoThon 2024, Online
Feb. 15, 2024
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Global Summit on War & Cancer 2023, Online
Dec. 14-16, 2023