Margaret Van Meter, MD

Discussion of emerging treatment options in HR+/HER2- metastatic breast cancer. EMBER-3, evERA, and ASCENT-07 Nick Turner of @royalmarsdenNHS #SABCS25

evERA subgroup analysis: oral SERD giredestrant or SOC ET + everolimus after prior CDK4/6i. 55% with mESR1. 47% prior fulvestrant. Benefit maintained in PIK3CA/AKT1/PTEN pathway alteration, prior CDK4/6i. @hoperugo of @cityofhope #SABCS25

EMBER-3 update: imlunestrant after progression on first-line AI+/-CDK4/6i. Median follow-up 28 mo. *OS benefit 11.4 mo in imlun. alone, across subgroups *PFS benefit imlun+abema in CDK4/6i-pretreated; OS trend annalsofoncology.org/article/S0923-… @jhaveri_komal @MSKCancerCenter #SABCS25

WISDOM: smarter screening, not more screening Risk-based breast cancer screening, age 40-74, no prior breast cancer. No increase in stage >=2B or 2A. Fewer mammos in risk-based arm. 77% completed genetic testing. jamanetwork.com/journals/jama/… Laura Esserman @UCSFSurgery #SABCS25

Real and sham accupuncture for cognitive difficulties in breast cancer survivors. 10 weekly sessions, 20-30 min, focused on sleep, cognition, other symptoms. Subjective improvement in both groups vs usual care; objective improvement in real. @JunMaoMD @MSKCancerCenter #SABCS25

YES: ePRO/chat room/journal tool in AYAs <3 years from end of active treatment for breast cancer, emphasizes self-management and self-monitoring. Improved QoL, no significant change in depression/anxiety. Some symptoms improved. @AnnPartridgeMD @DFCI_BreastOnc #SABCS25

PREFER: explored factors associated with acceptance of fertility preservation measures in women with early breast cancer. No difference in breast cancer outcomes in those who received controlled ovarian stimulation for oocyte cryopreservation. @matteolambe @SABCS25

Matched prospective study: breast cancer incidence not increased in BRCA1/2 carriers who used menopausal hormone therapy after rrBSO; lower incidence in estrogen alone group. No difference by route or type of E/P. Still knowledge gaps. Joanne Kotsopoulos of @WCHospital #SABCS25

EA1183: Use of FDG-PET/CT and mPERCIST criteria for assessment of treatment response in breast cancer with bone metastases. @eaonc @drjenspecht of @fredhutch #SABCS25

Lower incidence of brain metastases in patients with HR+ HER2+ metastatic breast cancer treated with palbociclib in addition to HER2-targeted therapy in the PATINA trial. No scheduled CNS imaging surveillance in the trial. @Otto_DFCI @DFCI_BreastOnc #SABCS25

Tour de force review of treatment of metastatic TNBC by @stolaney1 of @DFCI_BreastOnc. A few key points below, but highly recommend watching the entire session! #SABCS25

Adjuvant radiation in non-low-risk DCIS HR 0.49 with boost, benefit across subgroups No difference in OS 3 randomizations, each evaluating +/- boost median follow-up 10.2 yrs Majority age 50+, unifocal, <=2 cm, margins 2+ mm Boon Chua @BIGxResearch @TROGfightcancer #SABCS25

Omission of SLN in cT1-2 N0 treated with BCS 83% cT1 87% HR+ HER2- 52% received no adjuvant systemic therapy 5 year regional recurrence free survival noninferior Follow-up ongoing Marjolein Smidt @MaastrichtUMC #SABCS25

DCIS patient education resources

Excellent discussion of low-risk DCIS management by @DrEricWiner @SmilowCancer #SABCS25 *No RCT of DCIS treatment has ever shown OS benefit *Do as little as possible without compromising safety in any way *No "right choice" - patient preference is key

A011104: Breast MRI does not improve locoregional recurrence rates in prospective RCT. No differences by age or tumor subtype. Also no difference in distant recurrence or overall survival. Isabelle Bedrosian of @MDAndersonNews #SABCS25 @ALLIANCE_org

Multimodal multitask deep learning model using H&E images and clinical features is prognostic for distant recurrence in HR+ breast cancer independent of treatment. Not predictive of treatment benefit. Terry Mamounas #SABCS25

Presence of ctDNA in the PALLAS study is strongly prognostic for recurrence in early breast cancer. Await additional data on impact of CDK4/6i in reducing recurrence. @hthrparsons of @fredhutch #SABCS25

Discussion by @DrLisaCarey lidERA data *First positive data for adjuvant SERD; other studies ongoing *No data yet in patients treated with full course of adjuvant CDK4/6i *Cost of giredestrant could be substantial - perhaps >$20,000 per month. #SABCS25

lidERA: adjuvant oral SERD and ER antagonist giredestrant vs ET. 40% premenopausal, 50% stage II, 40% stage III. 80% received prior chemo. 3-yr IDFS 92.4% vs 89.6%, HR 0.70. Benefit across subgroups. DRFI improved, HR 0.69. OS immature. @dradityabardia #SABCS25