Armando Orlandi, Medical Director at the Agostino Gemelli University Hospital Foundation IRCCS, shared a post on X:
“Cowabunga! Riding Breast Cancer’s Biggest Data’s Wave from ASCO2026 Breast Cancer
5 questions that could change clinical practice. From the OR to the infusion chair – here’s what I’m watching.
SENOMAC (LBA503) (Sat May 30) Hall B1 OS data: can we safely omit ALND in SLN macrometastases? If NI confirmed – surgical de-escalation extends Z0011 to the macromet setting. The most awaited surgical result in years.
OPTIMA (500) (Sat May 30) Hall B1 Should genomic testing guide chemo omission in high-clinical-risk ER+/HER2- early BC? If confirmed – we stop overtreating patients whose genomics say no. Mature OS/DFS data.
REDUSE (1064) (Tue Jun 2) Hall D1 Denosumab every 12w vs every 4w — NI for SRE prevention? Most underrated trial at ASCO2026. If positive: fewer visits, lower costs, less ONJ risk. Every single bone-met patient benefits.
Iza-bren (LBA1003) (Tue Jun 2) Hall D1 Izalontamab brengitecan (HER3-ADC) vs chemo in LA/mTNBC. First phase III of a HER3-ADC in TNBC. If positive – new therapeutic class in breast oncology’s toughest setting.
The oral SERD story (Tue Jun 2) Hall D1 persevERA (LBA1006): giredestrant + palbociclib vs letrozole + PALBO in 1L HR+/HER2-. Press release: NEGATIVE. Oral SERDs don’t beat the AI when given to everyone upfront.
…but SERENA-6 (LBA1007) asks a smarter question: don’t replace the AI for all — switch to camizestrant only when ctDNA detects emerging ESR1 mutations. If PFS2 positive – pivotal for FDA (camizestrant already EMA-approved). Better for whom, and when?
PersevERA failed because it treated everyone the same. SERENA-6 — maybe — succeeds because it treats the right patient at the right moment. That’s not just a SERD story. That’s a precision oncology story.”
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