Sergio Cifuentes, Medical Oncologist at Las Américas Auna Clinic, shared a post on X:
“SABCS25 Highlight — New Treatment Algorithm for mTNBC from Sara Tolaney
One of the updates from SABCS25 is this proposed new therapeutic algorithm for metastatic triple-negative breast cancer (mTNBC) — integrating recent advances across antibody–drug conjugates, immunotherapy, and targeted therapy.
PD-L1–positive (1L)
- Â Sacituzumab govitecan + pembrolizumab emerges as a frontline option.
PD-L1–negative (1L)
- Â Datopotamab deruxtecan, reshaping expectations for ADCs in early lines.
-  Sacituzumab govitecan or PARP inhibitors (olaparib/talazoparib) for BRCA-mutated disease. • Reinforces the importance of germline testing early. 2L and beyond
-  Movement toward sequencing ADCs: SG → T-DXd (if HER2-low).
-  Continued role of PARP inhibitors in BRCA mutation carriers. •
Chemotherapy reserved for later lines or biomarker-directed choices (MSI-H, TMB-H, NTRK/RET fusions).
Why this matters This evolving landscape highlights:
- The shift toward ADC-first strategies in mTNBC
- The growing relevance of HER2-low classification even in TNBC
- The need for comprehensive biomarker testing at diagnosis
- A clearer, more personalized roadmap for sequencing therapies
mTNBC is rapidly changing — these updates may redefine frontline and subsequent treatment decisions globally.”
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