Medical Oncologist. Breast and Gyn cancer. BP - A Beneficência Portuguesa de São Paulo
São Paulo, Brasil
Joined July 2010
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Maximiliano Guedes retweeted
- PFS delta with tucatinib added to capecitabine/trastuzumab: 2.2 months (7.8 vs 5.6, #HER2CLIMB)
- PFS delta with tucatinib added to T-DM1: 2.1 months (9.5 vs 7.4, #HER2CLIMB-02)
- PFS delta with tucatinib added to maintenance HP: 8.6 months (24.9 v 16.3, #HER2CLIMB-05)
Maximiliano Guedes retweeted
We’ve long treated HER2+ breast cancer similarly. Until everything changed.
Within 1 year, T-DXd moved earlier, palbo and tucatinib reshaped maintenance, some chemos are nearly gone, biomarkers guide us.
The right-sizing era for HER2+ BC has begun.
nature.com/articles/s41571-0… 🧵1/
Maximiliano Guedes retweeted
🚨 NEW ASCO 2026 GUIDELINE: Recurrent Ovarian Cancer
A practical treatment algorithm worth saving 👇
PLATINUM-SENSITIVE recurrence
→ Platinum doublet remains backbone:
• Carboplatin + PLD
• Carboplatin + paclitaxel
• Carboplatin + gemcitabine
→ Bevacizumab may be added, followed by maintenance bevacizumab
→ Do NOT add trabectedin to PLD
PLATINUM-RESISTANT / REFRACTORY
⭐ FRα-high: Mirvetuximab soravtansine = strong recommendation
Other options:
• PLD
• Paclitaxel
• Bevacizumab + chemotherapy
• Relacorilant + nab-paclitaxel
• Gemcitabine
SURGERY
Secondary cytoreduction is not routinely recommended based on current evidence, but may be discussed when complete gross resection is highly achievable.
HIPEC
Evidence remains insufficient for a routine recommendation.
Key message:
Recurrent ovarian cancer is becoming increasingly biomarker-driven and patient-selected, especially in platinum-resistant disease.
@ASCO @JCO_ASCO @OncoAlert
#OvarianCancer #GynOnc #Oncology
Maximiliano Guedes retweeted
Right-sizing treatment for HER2-positive breast cancer: evolving algorithms across the disease continuum
Great review👇
@PTarantinoMD et al ✨️✨️
nature.com/articles/s41571-0…
Maximiliano Guedes retweeted
Advances in Systemic Treatment of Breast Cancer
nejm.org/doi/10.1056/NEJMra2…
Maximiliano Guedes retweeted
Efficacy & safety of pembrolizumab–lenvatinib in metastatic endometrial cancer: results from the French multicenter EAP in @ESMO_Open. 351 pts, mPFS 6.0 months, mOS 21 months. Reduced starting lenvatinib dose (n:129) did not impact PFS. esmoopen.com/article/S2059-7…
Maximiliano Guedes retweeted
ESMO 2026 cervical cancer update:
◽For locally advanced disease, cisplatin-based CCRT + MRI-guided IGABT remains the backbone.
◽Pembrolizumab adds a clear PFS and OS benefit in FIGO IIIA–IVA based on KEYNOTE-A18.
esmoopen.com/article/S2059-7…
@OncoAlert @myESMO
Maximiliano Guedes retweeted
Uncertainty about treatment after T-DXd remains.
In a new French real-world series of 105 patients with HER2+ metastatic breast cancer treated with tucatinib + trastuzumab + capecitabine (TTC) after T-DXd, 92% received TTC in the third-line setting. Median PFS was 4.7 months, median OS 15.3 months, and ORR 29.6%. Brain metastases were present in 55% of patients, with a median PFS of 4.9 months in this group.
These findings are quite consistent with previous post–T-DXd TTC series and add to the accumulating evidence for tucatinib, particularly in patients with CNS disease.
But as T-DXd + pertuzumab moves into the first-line setting, the key question changes:
After first-line T-DXd + pertuzumab, should we use the previously unused taxane + trastuzumab + pertuzumab, or tucatinib + trastuzumab + capecitabine in the second line?
We currently have no comparative data to answer this question. We have moved T-DXd earlier; now we need to redefine what should come after it.
thebreastonline.com/article/…
Maximiliano Guedes retweeted
In ER-positive, HER2-negative advanced breast cancer, giredestrant, an ER degrader and full ER antagonist, plus everolimus led to longer progression-free survival than standard endocrine therapy–everolimus; safety was similar. Full phase 3 evERA Breast Cancer trial results: nej.md/47ryfbF
ALT A graph from an Original Article published in the New England Journal of Medicine article titled "Giredestrant plus Everolimus in Advanced Breast Cancer." The graph shows progression-free survival among patients with ESR1-mutated tumors. The trial name, evERA Breast Cancer, is in parentheses after the title. The NEJM identity sits at the bottom.
Maximiliano Guedes retweeted
70-gene signature MammaPrint for early-stage HR-positive, HER2-negative breast cancer: outcome in the MINDACT trial for key clinical-pathological high-risk subgroups - European Journal of Cancer ejcancer.com/article/S0959-8… – at Kakkodi, India
Maximiliano Guedes retweeted
Surgery-First Versus Neoadjuvant Chemotherapy in Stage I (cT1c) Triple-Negative Breast Cancer: A Critical Reappraisal - The Breast thebreastonline.com/article/… – at Kakkodi, India
Maximiliano Guedes retweeted
Beyond a single disease: review of rare histological subtypes of triple-negative breast cancer with implications for prognosis and treatment
Great review👇
nature.com/articles/s41523-0…
Maximiliano Guedes retweeted
Molecular subgroups and biomarker guided precision immunotherapy in triple-negative breast cancer: advances, challenges, and future directions dlvr.it/TVQ2BG #FrontImmunol
Maximiliano Guedes retweeted
New 📰looking at the chemotherapy type and survival in young BRCA1/2 carriers with HER2-negative early #BreastCancer.
🔓 pubmed.ncbi.nlm.nih.gov/4258…
@dimeglio_anto @ElisaAgostinett @JyotiBajpai01 @judithbalmana @fedrophd @AnnPartridgeMD @angela_toss @Dra_CVillarreal @DenizCanGuven1 @CuiWanda @vitti10 @DrShelleyHwang @puglisi_fabio @CarmineDeA1 @BlondeauxEva @matteolambe
Maximiliano Guedes retweeted
New review on #ctDNA in @JournalCancer 👉Circulating tumor DNA in early #BreastCancer: Evidence, challenges, next steps.
pubmed.ncbi.nlm.nih.gov/4242…
@ReduzziCarol @ValenzaCarmine @LGerratana @ElisaAgostinett @MIgnatiadis @JavierCortesMD @curijoey @PruneriG
Maximiliano Guedes retweeted
Ovarian reserve predicts chemo benefit in RxPONDER (HR+/HER2-, node+, premenopausal <55):
🔹 AMH ≥10 pg/ml → CET cuts recurrence risk ~54% (HR 0.46)
🔹 AMH <10 pg/ml → no chemo benefit (HR 1.27)
Estradiol/FSH/LH/progesterone: not predictive. @Larvol @OncoAlert
Maximiliano Guedes retweeted
mTNBC recurring 14 months post-KN522. CPS 15. Is she an "IO candidate"? If yes, you reach for ASCENT-04. If no, Dato-DXd or SG monotherapy. How are you sequencing the new 1L approvals in the clinic? #bcsm #TNBC
63%SG + pembrolizumab
18%Dato-DXd
8%SG monotherapy
11%Chemo + pembrolizumab
114 votes • Final results Maximiliano Guedes retweeted
Stefania Morganti, MD (@StefiMorganti) shares treatment updates on the management of HER2+ Metastatic Breast Cancer, including @DanaFarber recommendations for first-line and maintenance therapy. #DanaFarberBreastCancerCourse #MBC #BreastCancer #bcsm #MetastaticBreastCancer
Maximiliano Guedes retweeted
And it is on again!
The Annual Mayo Clinic Oncology Review. First up is @rleonferre talking about HER2+ and triple negative breast cancer. As expected, a superb presentation, packed with pearls!
A full day ahead, packed with exciting updates. Join us next year!
@MayoCancerCare @MayoHemeOnc @MayoMedEd
Maximiliano Guedes retweeted
🚨 New in @JCOOP_ASCO from @maxwellRlloyd et al. 👇
Review of the evidence for emerging ER-targeted monotherapies and combination strategies across metastatic and curative-intent settings, addressing key questions on treatment selection and sequencing
🔗 doi.org/10.1200/OP-26-00199
