Caroline Michie, Consultant Medical Oncologist at Spire Murrayfield Hospital, shared a post on LinkedIn:
“Reflections on ESMO Congress 2025.
As ESMO 2025 closes, I have listed a few of my top presentations. It was a brilliant conference for new breast cancer data, and with nearly 35000 delegates overall it was bigger than ever. I’m missing SABCS this year (my husband turns 50), so it was great to have such a good meeting close to home with lots of networking.
The rise of ADCs continues, and it was especially good to see multiple studies presented that we were involved in.
In no particular order;
ASCENT-3 and TROPION-breast02 – both showed significant benefit of topo-1 ADCs in the 1L treatment of metastatic/LA TNBC. Both studies showed meaningful improvements in PFS, although the recruited populations and control arms were slightly different. They also showed ~30% of patients were still progression-free at 24 months, a remarkable statistic given historical data.
Thoughts – We do need better biomarkers to identify who the responding patients are, and it remains clear there is still a significant unmet need overall. I really look forward to seeing whether post-neoadjuvant ADC studies eg, TROPION-breast03 and TROFUSE12, both studies we are/were recruiting to in Edinburgh, will translate into more cures. Sadly, 50% of pts will not be well enough for 2L treatment, but one major question is what to offer after PD on these more active agents.
DESTINY-breast05 and DESTINY-breast11 studies of adjuvant and neoadjuvant (respectively) T-DxD for high-risk early HER2+ BC.
Both trials continue to demonstrate the enhanced efficacy of T-DxD. I am especially keen to see whether the incidence of CNS disease will be meaningfully reduced with longer FU, as ~50% of patients relapsing after T-DM1 have been shown to sadly have CNS disease. A major talking point was what to offer if residual disease present after neoadj T-DxD; we will await the key EFS data with interest from DESTINY 11….
NATALEE and MONARCH-E 5y and 7y updates respectively of adjuvant CDK4/6 inhibitors both confirm benefit with longer follow up, although full OS benefits will naturally need more time. One point concerned me re the high frequency of transformed disease (from ER/PR+ to ER/PR -ve) on recurrence following adj CDK4/6i which needs more interrogation.
Nice PRO data from ASCENT-4, PATINA and SERENA-6 were presented as well as multiple subgroup analyses from DESTINY-breast09 (1st line T-DxD)
One study generating much discussion was the PLANET study from India, a small single-centre of just 3 doses of dose-reduced 50mg neoadj Pembrolizumab along with AC-pac which showed a 13% uplift in pCR.
OS data from the Dutch SONIA trial showed no difference in OS between 1L vs 2L CDK4/6i, although overall the OS was lower than expected. Very interesting data for frailer patients especially.
Multiple oral SERD and PI3Ki trial data presented also worth looking at in metastatic ER+ HER2- BC
Very welcome longer FU data from the POSITIVE trial (pregnancy after BC).”
Follow the latest ESMO 2025 news on OncoDaily.
