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Olubukola Ayodele/LinkedIn

Jun 1, 2025, 05:46

Olubukola Ayodele: Day 2 of ASCO2025

Olubukola Ayodele, Consultant Medical Oncologist at the University Hospitals of Leicester NHS Trust, posted on LinkedIn:

“Day 2 of ASCO2025.

Today’s oral abstract presentation of ASCENT-04 / KEYNOTE-D19 (LBA109) brought game-changing data and real hope for patients with PD-L1+ metastatic triple-negative breast cancer (TNBC).

This Phase 3 trial compared sacituzumab govitecan (SG) + pembrolizumab vs chemo + pembrolizumab in previously untreated, PD-L1+ (CPS ≥10) locally advanced/metastatic TNBC.

And the results?

Median PFS:

SG + pembro = 11.2 month
Chemo + pembro = 7.8 months
(HR 0.65; P = .0009)

Median duration of response (DOR):

SG + pembro = 16.5 months
Chemo + pembro = 9.2 months

ORR:

59.7% (SG + pembro) vs 53.2% (chemo + pembro)

Fewer treatment discontinuations due to side effects with SG + pembro (12% vs 31%)

Even though overall survival (OS) data is still maturing, there is already a positive early trend. For me as a breast oncologist, this trial marks a pivotal shift. Sacituzumab govitecan already proven in heavily treated TNBC is now showing power upfront, in combination with immunotherapy.

Here’s what stands out:

Durability of response is impressive.
Better tolerability profile than standard chemo combos.
Meaningful impact on quality of life by delaying progression and reducing discontinuation rates.

It also reaffirms a vital point: we must design more trials that challenge conventional first-line choices. In a setting like TNBC that is historically so unforgiving, patients deserve better than “chemo-first” by default. Approximately, 50% of patients do not receive second line treatment. 34% die before second line treatment.

While we await OS data, this combination is already reshaping the treatment landscape for PD-L1+ TNBC. The path forward must include access, equity and real-world validation but the science is encouraging.

Well done to the ASCENT-04 team (Sara Tolaney et al). This data should redefine the standard of care.”

Olubukola Ayodele: Day 2 of ASCO2025