Armando Orlandi, Medical Director at the Agostino Gemelli University Hospital Foundation IRCCS, shared a post on LinkedIn:
“ESMO 2025 Day 4: Updates and New Combinations Across HR+, HER2+, and TNBC
Monday, October 20th delivered pivotal insights that will influence treatment sequencing decisions and introduce promising new agents to our armamentarium:
Key HR+/HER2- Advances:
- SONIA Trial OS Analysis: Important academic effort examining CDK4/6i sequencing showed no OS difference between first-line vs second-line use (47.9 vs 48.1 months). While these data provide valuable real-world insights, interpretation requires consideration of patient selection biases and cost-effectiveness implications
- CULMINATE-2: Novel CDK2/4/6 inhibitor culmerciclib + fulvestrant showed impressive PFS benefit (HR 0.56) with manageable toxicity in first-line setting
- PIKALO-1: LY4064809, a pan-mutant-selective PI3Kα inhibitor, demonstrated encouraging activity with notably lower class toxicities – only 1% Grade ≥3 hyperglycemia
Combination Strategies:
- SHR-A1811 + Pertuzumab: Impressive 77.3% ORR in HER2+ mBC with 91% 12-month PFS rate
- BEGONIA Update: Datopotamab deruxtecan + durvalumab achieved remarkable 79-81.8% cORR in first-line TNBC with manageable safety profile.”
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