Amol Akhade, Senior Consultant at Fortis Hospitals Mumbai, shared a post on LinkedIn:
“ESMO25 Day 2 — Big Signals, Better Questions
Breast
1. DESTINY-Breast11 (Neoadj HER2+)
- pCR 67.3% vs 56.3%; EFS HR ≈ 0.56 (immature); ILD ~4.4% vs 5.1%.
- Anthracycline-free regimen + deeper responses.
- But pCR ≠ OS — need survival data + cost/ILD monitoring remain real-world hurdles.
2. DESTINY-Breast05 (Residual HER2+)
- IDFS & iDFS HR 0.47 (T-DXd vs T-DM1);
- ILD 9.6% vs 1.6%.
- Raises the bar for very-high-risk residual disease.
- Toxicity/affordability remain key gating factors.
3. evERA (HR+ post CDK4/6) — ESR1-mut subgroup
- mPFS ~10 mo vs 5.5 mo (HR ~0.38);
- OS HR ~0.62 (immature).
- Logical combo (SERD + mTOR) in ESR1-mut patients.
- Broader benefit still unproven; wait before broad rollout.
4. VIKTORIA-1 (HR+/HER2– post CDK4/6, PIK3CA-WT)
- mPFS 9.3 mo vs 2.0 mo (HR 0.24);
- AEs: hyperglycaemia ~9%, diarrhoea ~17%.
- Huge PFS gain in difficult setting — but OS & real-world tolerability pending.
GU (Bladder)
5. KEYNOTE-905 (EV + Pembrolizumab, cis-ineligible MIBC)
- 2-yr EFS 74.7% vs 39.4% (HR 0.40);
- 2-yr OS 79.7% vs 63.1% (HR 0.50).
- Practice-changing for cis-ineligible MIBC.
- Access to EV + cost remain real-world constraints.
Gynecologic
6. KEYNOTE-B96 (Platinum-resistant Ovarian)
- mPFS 8.3 vs 7.2 mo (HR 0.72); OS HR ~0.76; benefit mainly in PD-L1 ≥1.
- Modest benefit in challenging space — patient selection vital.
GI
7. PEGASUS (ctDNA-guided Stage II-III Colon)
- Enrolled 135 pts (100 LB–, 35 LB+).
- 2-yr DFS LB– 88% (90% CI 81–93) vs LB+ 61.8% (HR ~2.71; p=0.0036);
- 2-yr OS LB– 93.8% vs LB+ 79.7% (HR ~3.11; p=0.0383).
- Strong prognostic biomarker data, but guiding therapy still unclear.
8. NICHE-2 (dMMR Colon, Neoadj ICI)
- Neoadjuvant Nivolumab + Ipilimumab far outperform chemo in dMMR early colon cancer.
- NICHE-2 (dMMR colon cancer): 111 patients received short-course neoadjuvant nivolumab + ipilimumab — 95% achieved major pathologic response, 67% complete response, and 3-year DFS 100% with no recurrences.
- dMMR = immunotherapy disease; upfront testing non-negotiable.
9. COMPETE (GEP-NETs, ^177Lu-edotreotide vs Everolimus)
- Median PFS 23.9 mo vs 14.1 mo (HR 0.67, 95% CI 0.48-0.95; p=0.022) in Grade 1/2 SSTR+ GEP-NETs.
- Dosimetry: tumor absorbed dose ~110.0 ± 90.8 Gy vs kidneys ~12.5 ± 4.4 Gy.
- Radioligands win again — key challenge now: access & radionuclide capacity.
Lung
10. MDT-Bridge (Borderline/Resectable NSCLC, Neoadj Durvalumab + Chemo)
- ~140 pts (Stage IIB–IIIB).
- Two cycles neoadj D + CT → MDT reassess;
- ~95% proceeded to local therapy if initially resectable,
- ~82% if borderline.
- Early feasibility signal: chemo-IO + strong MDT pathway may expand resectability.
Head & Neck
11. CompARE (Durva + CRT in Oropharyngeal Cancer, Intermediate/High Risk)
- Phase III negative overall; possible hint of benefit in very high-risk subgroup.
- Another reminder: adding IO everywhere ≠ smart. Biomarker selects.”
You Can Also Read:
Inside ESMO25 Day 1 With Amol Akhade
ESMO 2025 Day 1 Highlights Not to Miss
ESMO 2025 Day 2 Highlights Not to Miss
