My trip to Cancer De Mama LACOG-GBECAM 2025 has been wonderful.

Learning about the stark differences in access between public and private patients has been eye opening.

No IO, ADCs, CDK4/6 for public pts.

#medsky #oncosky

Dr Kaelin gave a very thought provoking talk.

He argues single agent therapies will never cure cancer due to resistance.

Our chance is cure will come with multiple non-cross resistant therapies, challenging current paradigms.

#bcsm

Active monitoring for low risk DCIS non-inferior at 2 years to surgery.

I would like to see some longer follow-up but this challenges current paradigms.

@SABCS24 #SABCS24

jamanetwork.com/journals/jam...

The next big thing in Triple Negative Breast Cancer:
VEGF/PD-1 Bispecifics.

Wonderful discussion by Dr. Thomas Grinda on the prospects.

Several Phase III studies planned.

@oncbrothers.bsky.social @sabcs.bsky.social @oncoalert.bsky.social

Primary results of ABEMAIMMUNE (NCT04352777).

Single cell sequencing on CD45+ cells in HR+, HER2- pts at baseline + 4 wks on ET/abemaciclib.

Enhanced cytotoxic T cells, NK cells= good!
For the 1st time, we show unique changes to the myeloid compartment including a ⬇️ in TREM2+ LAMs.

#SABCS24

RLY2608 is a mutant specific PIK3CA inhibitor sparing Wildtype Receptor.

2nd line PFS >11 months with fulvestrant.

Improved safety profile with low grade hyperglycemia, no rash, diarrhea, or oral sores.

Hoping this one moves forward!

#SABCS24 @oncoalert.bsky.social @oncbrothers.bsky.social

What about delayed immune mediated toxicity?
Jacobs et al:
700 pts all stages; 84% TNBC, 74% Early-stage
Incidence: 61% iTox any time; 34% delayed iTox

8.6% with iTox AFTER TREATMENT
4.7% with iTox 1 year AFTER ICI INITIATION

Should we be checking endocrine labs for years after ICI ?
#SABCS24

LeVee et al; Real world immune mediated toxicity (iTox) in >400 early stage breast cancer pts in multi-institutional study.

Nearly 73% incidence of all grade iTox!
2x higher than reported in Keynote 522.

Age >50 and CDK risk factors for iTox

@oncbrothers.bsky.social #SABCS24

PADMA study: ET + palbo versus chemo in 1st line HR+, HER2- disease.

ET + palbo better. Mirrors Right Choice and Young Pearl.
CDK4/6 + ET remains SOC in most patients. Chemo is not beneficial first.

I only use chemo for true liver failure, bone marrow failure etc.
#SABCS24

Dr. Waks from @dfcibreastonc.bsky.social presents MARGOT assessing margetuzumab, pertuzumab, taxane versus trastuzumab, pertuzumab, taxane in Stage II/III HER2+ disease.

No statistically significant improvement in pCR.
However, pCR in ER-, HER2+ w/ 12 wks of THP is >70% supporting de-escalation.

For anyone looking to cut screen time on their phones to be present, improve focus. I bought an app called Opal that literally blocks your apps after a self selected time limit.

I’m down 82% this week! 21 hours of my week back…

(I get no Opal kickbacks😂)

Dr Yang from NYU gives an Excellent talk on Proton CranioSpinal Radiation for LMD.

Best for high KPS, breast patients, low CTCs in CSF, stable extra cranial disease.

#bcsm

Excited for the SNO Annual Conference this weekend where I will be discussing "Systemic Therapies for Breast Cancer LMD: A Paradigm for Multidisciplinary Coordination"

Intrathecal Chemo is OUT. Systemic Therapies with CNS Bioactivity Are In.

More to come Sunday! #oncsky #bcsm