Olubukola Ayodele, Breast Cancer Lead at University Hospitals of Leicester NHS Trust, shared on LinkedIn:
“As I begin to prepare for ESMO 2026, I’ve been reviewing the breast cancer programme asking one question: what could actually change practice?
The late – breaking abstracts are out, and these are the 10 studies I’ll be watching closely.
- Can immunotherapy finally find a place in HR+/HER2-negative advanced breast cancer? Keynote – B49 may give us an answer.
- What should we do after progression on a CDK4/6 inhibitor? postMonarch asks whether switching to abemaciclib after progression on a previous CDK4/6 inhibitor can translate into an overall survival benefit, while Finer explores another route through AKT inhibition.
- Then there is the rapidly expanding ADC landscape.
Panku – Breast01 is evaluating an EGFR×HER3 bispecific ADC. Horizon – Breast06 and Apex – Breast01 bring new HER2 – directed ADCs into HER2 – low metastatic breast cancer.
We have spent the last few years asking whether ADCs work. We increasingly know they do.
The harder question now is: which ADC, for which patient, at what point in the pathway, and what comes next when it stops working?
If you need a refresher on ADCs, I explained how they work here.
- I’m also particularly pleased to see dedicated prospective studies addressing CNS disease.
Bridget asks a very practical question. If a patient with HER2 – positive metastatic breast cancer develops isolated brain progression while the rest of their disease remains controlled, do we really need to abandon an otherwise effective systemic treatment?
Inspire – LM tackles an even more difficult clinical situation: HER2-positive leptomeningeal disease, where prospective evidence remains desperately needed.
- Then there are the survival questions.
We already know Natalee improves invasive disease – free survival. At six years, I want to know whether that benefit is translating into improved overall survival.
In metastatic TNBC, Opti Trop – Breast01 gives us the final OS analysis of sacituzumab tirumotecan versus chemotherapy.
What will I be looking for when the data appear?
Not just statistical significance. I want to know the absolute benefit, toxicity, which patients are driving the result, and whether the comparator reflects what we actually do today.
Because a positive trial and a practice – changing trial are not necessarily the same thing.
There is one more question I will always ask:
If this does change practice, how many of our patients will actually be able to access it?
See you in Madrid.”
Other articles featuring Olubukola Ayodele on OncoDaily.