Armando Orlandi, Medical Director at the Agostino Gemelli University Hospital Foundation IRCCS, shared a post on LinkedIn:
“SABCS 2025 Day After
The 10 Key Takeaways Every Breast Cancer Oncologist Needs to Know
Four days of presentations in San Antonio have shaped the future of our clinical practice. Here are the data that will define 2026 and beyond:
- lidERA – First oral SERD to win in early BC. Giredestrant vs standard ET in HR+/HER2- EBC: iDFS HR 0.70 (p=0.0014), 3y iDFS 92.4% vs 89.6%. The first improvement in adjuvant endocrine therapy in over 20 years.
- HER2CLIMB-05 – The era of enhanced maintenance. Tucatinib + HP maintenance in 1L HER2+ MBC: PFS HR 0.64 (p<0.0001), mPFS 24.9 vs 16.1 months. Effective with and without brain metastases.
- AXSANA – Axillary de-escalation validated globally. 6,474 patients across 26 countries, cN+ → ycN0 post-NAC: 3y ARFS 98.8% (TAD/SLNB) vs 99.2% (ALND). Non-inferiority confirmed.
- Adjuvant Carboplatin in TNBC – Two Chinese trials confirm survival benefit: RJBC 1501 OS HR 0.39 (p=0.029); CITRINE OS HR 0.41. Consistent across all subgroups.
- DETECT V – Final analysis: chemo-free + ribociclib in triple-positive MBC. HP + ET non-inferior to HP + chemo; adding ribociclib: PFS HR 0.48, OS HR 0.43. A concrete new possible option.
- Multimodal AI – The future of risk prediction is here. Integration of imaging, clinical, and molecular data to predict both early AND late recurrence (5-10 years), outperforming current genomic assays.
- ctDNA MRD – The definitive prognostic marker. GeparDouze (TNBC): MRD+ post-surgery → 78% recurred; MRD- → 95% recurrence-free. HR for distant recurrence: 30.3.
- WISDOM – Personalized screening is safe and preferred. 46,000 women: stage ≥2B non-inferior (actually lower). 89% of women chose a risk-based approach.
- TILs – Ultra-validated and available now. CompassHER2: ↑10% TILs = ↑26-31% odds of pCR. APHINITY: AI identifies 10% more patients benefiting from pertuzumab. Free, on H&E, no excuses.
- PI3K Pathway Expansion – Beyond PIK3CA. EPIK-B5: Alpelisib post-CDK4/6i OS HR 0.64 (p=0.021). VIKTORIA-1: Gedatolisib works in PIK3CA-WT (triplet PFS HR 0.24). PIK3R1: the forgotten 3.2%, sensitive to all PI3Ki. Testing beyond PIK3CA mutations matters.
The landscape is evolving rapidly: new standards emerging, de-escalation validated, AI and liquid biopsy transforming risk prediction. 2026 will be a pivotal year for breast cancer care.”
More posts featuring Armando Orlandi.