🌸 THE 10 MOST IMPORTANT BREAST CANCER TRIALS OF #ASCO26 Chicago is loaded this year. From ctDNA-guided endocrine switching to frontline ADCs and next-gen HER2 platforms, these are the studies most likely to shape breast oncology practice 👇 🩷 HR+ / HER2- DISEASE 1️⃣ persevERA BC (LBA1006) Giredestrant + palbociclib vs letrozole + palbociclib in 1L metastatic disease Despite missing the primary PFS endpoint, biomarker/subset analyses may define where oral SERDs still fit. 2️⃣ SERENA-6 (LBA1007) Camizestrant for emergent ESR1 mutations detected via ctDNA BEFORE radiographic progression Possibly the biggest ctDNA-guided endocrine strategy discussion of the meeting. 3️⃣ VIKTORIA-1 Gedatolisib + fulvestrant ± palbociclib after AI + CDK4/6i progression Huge unmet-need population. Post-CDK4/6 sequencing remains one of the biggest HR+ questions. 4️⃣ lidERA BC (Abstract 502) Adjuvant giredestrant in early ER+/HER2- disease Moving oral SERDs into curative-intent therapy. 5️⃣ FOURLIGHT-2 (Abstract 1042) Next-gen CDK4-selective inhibition with atirmociclib + letrozole Can we reduce neutropenia while preserving efficacy? 🔥 TNBC & ADC ERA 6️⃣ ASCENT-04 (LBA1000) Sacituzumab govitecan + pembrolizumab vs chemo + pembrolizumab in PD-L1+ mTNBC Could ADC + IO combinations become the frontline standard? 7️⃣ TROPION-Breast02 Dato-DXd vs chemotherapy in metastatic TNBC A major test of the “ADC-first” paradigm. 🎯 HER2+ & NEXT-GEN NEOADJUVANT PLATFORMS 8️⃣ KN026-004 (LBA660) Novel biparatopic HER2 antibody vs classic CLEOPATRA-style therapy Watch the pCR data carefully. 9️⃣ I-SPY 2.2 (LBA514) Rilvegostomig + T-DXd in high-risk HER2-negative disease IO + ADC combinations continue moving earlier. 🔟 DESTINY-Breast05 Update Long-term outcomes for T-DXd vs T-DM1 in residual HER2+ disease Which breast abstract are you watching most closely? #BCSM #OncoTwitter #ASCO26 #BreastCancer #MedEd @asco @myesmo @esmo_open @OncoAlert @OncBrothers

🚨 FDA expands the role of Enhertu in curative-intent HER2+ early breast cancer. AstraZeneca + Daiichi Sankyo’s trastuzumab deruxtecan is now approved in the US in BOTH: 🔹 Neoadjuvant setting (DESTINY-Breast11) 🔹 Adjuvant residual disease setting (DESTINY-Breast05) Key data 👇 🔹 DESTINY-Breast11 Enhertu → THP vs ddAC-THP 📈 pCR: 67.3% vs 56.3% Absolute improvement: +11.2% (p=0.003) 🔹 DESTINY-Breast05 Enhertu vs T-DM1 in residual disease 📉 IDFS events reduced by 53% (HR 0.47) 📊 3-year IDFS: 92.4% vs 83.7% This potentially reshapes BOTH pre-op and post-op HER2+ early breast cancer management. But important caution: ⚠️ ILD/pneumonitis remains clinically relevant. In DESTINY-Breast05: • ILD: 9.6% with Enhertu • 2 treatment-related deaths reported Still, this is a major move of T-DXd deeper into curative-intent disease. 📖 Full details: AstraZeneca press release #BreastCancer #OncoTwitter #MedTwitter @OncoAlert @myesmo @esmo_open @asco

🚨 AstraZeneca update in bladder cancer. Phase III VOLGA trial met its primary endpoint: Perioperative durvalumab (Imfinzi) + neoadjuvant enfortumab vedotin (EV) significantly improved EFS in cisplatin-ineligible or cisplatin-declining MIBC. 🔥 🧪 Trial arms: 1️⃣ Durvalumab + EV + tremelimumab 2️⃣ Durvalumab + EV 🆚 🏥 Radical cystectomy ± adjuvant therapy 📌 Key takeaways: ✅ Statistically significant & clinically meaningful EFS benefit ✅ Favorable OS trend ✅ Manageable safety profile ✅ Potential perioperative option for cisplatin-unfit patients After NIAGARA and POTOMAC, VOLGA becomes another major positive perioperative bladder cancer readout for durvalumab. The perioperative uro-oncology landscape is changing rapidly. 📖 Full release in comment ⬇️ #BladderCancer #uroonc #MedTwitter @OncoAlert @myesmo @esmo_open @asco @AstraZe

A new RAS era in pancreatic cancer? Daraxonrasib, an oral RAS(ON) multiselective inhibitor, showed activity in previously treated RAS-mutated PDAC. 🧬 Phase 1-2 | N=168 💊 Oral daily daraxonrasib 🎯 2L RAS G12, 300 mg: ORR 35% 📈 mPFS 8.5 mo | mOS 13.1 mo ⚠️ Grade ≥3 TRAEs: 30% Key nuance: single-arm early-phase study. Phase 3 RASolute 302 will define its real place. 📖 Full paper in comment ⬇️ #OncoTwitter #MedTwitter #PancreaticCancer #GIOnc @OncoAlert @myESMO @NEJM