#SABCS22
2. #PADMA: Ph III, HR+ metastatic breast cancer, chemo vs ET + Palbociclib.

- #SABCS22 in #RightChoice study, we knew CDK4/6i upfront is better.

- Time to treatment failure and PFS better in PADMA. CDK4/6i remain 1L SoC for these pts

3/5
December 11, 2024 at 2:26 AM
ADCs aren’t limited to HER2. Sacituzumab govetecan (Trodelvy) has an antibody to TROP2, is approved for metastatic TNBC and is in trials for ER+MBC. Other ADCs are also being explored. Hopefully effective one with fewer side effects can be developed. #SABCS22 #bcsm
November 17, 2024 at 11:25 AM
Not MBC, but an interesting study on breast density. BD ⬇️ with ⬆️ age and ⬆️ weight. In a breast that ultimately develops cancer, density ⬇️ slower than in the other breast in which cancer didn’t develop. Seems like we need a density score that can be followed. #sabcs22 #bcsm
November 17, 2024 at 5:41 AM
November 17, 2024 at 12:04 PM
But like everything else, there are side effects, mainly interstitial lung disease (aka one monitors or inflammation of the lungs). Nause can be pretty bad too, right @swaggsheila1? #HER2low #SABCS22 #bcsm
November 17, 2024 at 11:25 AM
No surprise but #FinancialToxicity disproportionately affects Black and Brown people. And when #ClinicalTrial participation means taking time off work, paying for parking, etc it also contributes to inability to be a clinical trial hero and get the data we need. #SABCS22 #bcsm
November 17, 2024 at 11:25 AM
What can we do about this issue? Lots. #SABCS22 #bcsm
November 17, 2024 at 11:25 AM
And why should we care? Because a ton of people who are classified as HER2- have 1+ or 2+ expression and could benefit from TDxD and maybe other HER2 targeted therapies. #HER2low #SABCS22 #bcsm
November 17, 2024 at 11:06 AM
#ClinicalTrials MUST be diverse to understand how drugs work - and what side effects are - in different populations. One solution is to involve diverse #advocates, diverse investigators, in every trial. We also MUST NOT assume certain people won’t participate. #bcsm #SABCS22
November 17, 2024 at 11:06 AM
What can oncologists do Monday AM to improve #PalliativeCare for their patients? First, explain that PC isnt hospice and it sure as heck isn’t “giving up” #SABCS22 #bcsm
November 17, 2024 at 11:06 AM
And the real kicker is #FinancialToxicity not only lead to increased burden on us and our families, it also kills #SABCS22 #bcsm
November 17, 2024 at 11:06 AM
The TROPICS trial showed mild (but statistically significant) improvement in PFS and OS. #SABCS22 #bcsm
November 17, 2024 at 11:06 AM
This improvement held whether one had high or low TROP2 expression #SABCS22 #bcsm
November 17, 2024 at 11:06 AM
Of course, saci has side effects, but treatment discontinuation was rare. Because high vs low TROP2 expression didn’t make a difference, screening patients for TROP2 levels isn’t necessary. These patients were pretty heavily pretreated so this is another option #SABCS22 #bcsm
November 17, 2024 at 11:06 AM
In those who are classically ER+ HER2+ targeting both seems logical, but how does the whole concept of HER2 low fit in? 🤷‍♀️ Would love to get some feedback from our smart oncologists and researchers. #SABCS22 #bcsm
November 17, 2024 at 11:06 AM
It’s like a seesaw: when 1 goes up the other goes down. #SABCS22 #bcsm
November 17, 2024 at 11:06 AM
Should a CDK4/6 inhibitor be added to the mix? Seems to work better but what about side effects?? There are ongoing trials. #SABCS22 #bcsm
November 17, 2024 at 11:06 AM
Currently approved ADCs for #metastatic HER2+ disease are TDM1 (Kadcyla) and TDXd (trastuzumab deruxtecan aka Enhertu). They work differently, have different efficacies, and different side effects, and we as patients should be involved in which to use. #SABCS22 #bcsm
November 17, 2024 at 11:06 AM
A newer TROP2 ADC on trial is datopotamab deruxtecan (nickname dato-DXd), also looking very promising in heavily pretreated mTNBC and trials planned/starting for use as 1st line therapy. Again keep your 👀 peeled. #SABCS22 #bcsm
November 17, 2024 at 11:05 AM
And wait, there’s more!! New targets, new payloads - this is a very active area of research
#SABCS22 #bcsm
November 17, 2024 at 11:05 AM
But what should we use when? How can we figure out what will work - or not work - in an individual patient? We need biomarkers, we need sequencing trials and comparative trials. And we need #advocares involved in the design/development of all of this!!!!. #SABCS22 #bcsm
November 17, 2024 at 11:05 AM
One thing not up for debate: a CDK 4/6 inhibitor (specifically ribociclib) + endocrine therapy is better than chemo in first line aggressive disease. #sabcs22 #bcsm
November 17, 2024 at 11:05 AM
Left #Cozumel 🤿 🐠 🏝 🍹 ☀️ 3 days early to go to #SABCS22 🧬 🔬 💙💚💗 Cannot wait to 🤗 #advocate, oncologist, and researcher friends and learn what might help keep us #NotDeadYet in the future! #MetastaticBreastCancer #bcsm
November 17, 2024 at 10:44 AM
First event (for me) at #SABCS22 is @abreastcancer/NBCC joint session on #HER2low where the last Kate Petrides was honored with a moment of silence. I think Kate would have preferred a moment of action. @metavivor #bcsm
November 17, 2024 at 10:44 AM
Hopping around between sessions at #sabcs22. You’ll hear a lot about biomarkers. We also need to know when and in whom to use a particular biomarker. #bcsm
November 17, 2024 at 10:44 AM