Tumor Board Tuesday
@tumorboardtuesday.bsky.social
Online Tumor Board with a molecular angle ~ Join us every Tuesday 8pm ET for discussions, polls, & mini tweetorials
Created by @mpishvaian.bsky.social • @MPishvaian • FREE CME
Created by @mpishvaian.bsky.social • @MPishvaian • FREE CME
#TumorBoardTuesday
This was a mountain of data to cover in a very fast moving treatment area - thank you so much @drgattimays.bsky.social and @KennaKoehler for this massive effort🙏
This was a mountain of data to cover in a very fast moving treatment area - thank you so much @drgattimays.bsky.social and @KennaKoehler for this massive effort🙏
a person stands on the top of a rocky mountain
ALT: a person stands on the top of a rocky mountain
media.tenor.com
October 22, 2025 at 1:26 AM
#TumorBoardTuesday
This was a mountain of data to cover in a very fast moving treatment area - thank you so much @drgattimays.bsky.social and @KennaKoehler for this massive effort🙏
This was a mountain of data to cover in a very fast moving treatment area - thank you so much @drgattimays.bsky.social and @KennaKoehler for this massive effort🙏
#PostTest Q2️⃣ #TumorBoardTuesday
🧐A 75yo♀️w/ ER+/HER2- PIK3CA+ mBC starts 2L Tx w/alpelisib + fulvestrant. Baseline A1C = 6.1 & BMI = 33. What steps can limit risk for severe hyperglycemia❓
1) Labs QW x 2, then Qmonth
2) Baseline A1C, then Q3 months
3) Consider metformin premed
4) All of the above
🧐A 75yo♀️w/ ER+/HER2- PIK3CA+ mBC starts 2L Tx w/alpelisib + fulvestrant. Baseline A1C = 6.1 & BMI = 33. What steps can limit risk for severe hyperglycemia❓
1) Labs QW x 2, then Qmonth
2) Baseline A1C, then Q3 months
3) Consider metformin premed
4) All of the above
Integrity CE
Learn more about the
integrityce.com
October 22, 2025 at 1:25 AM
#PostTest Q2️⃣ #TumorBoardTuesday
🧐A 75yo♀️w/ ER+/HER2- PIK3CA+ mBC starts 2L Tx w/alpelisib + fulvestrant. Baseline A1C = 6.1 & BMI = 33. What steps can limit risk for severe hyperglycemia❓
1) Labs QW x 2, then Qmonth
2) Baseline A1C, then Q3 months
3) Consider metformin premed
4) All of the above
🧐A 75yo♀️w/ ER+/HER2- PIK3CA+ mBC starts 2L Tx w/alpelisib + fulvestrant. Baseline A1C = 6.1 & BMI = 33. What steps can limit risk for severe hyperglycemia❓
1) Labs QW x 2, then Qmonth
2) Baseline A1C, then Q3 months
3) Consider metformin premed
4) All of the above
#PostTest Q1️⃣ #TumorBoardTuesday
🤔What 2L Tx would you offer a 45yo♀️w/ ER+/HER2- mBC and an AKT mutation on 🧪liquid biopsy after progression at cycle 47 of ribociclib ➕ AI/OFS❓
1) Capecitabine monotherapy
2) Capivasertib + fulvestrant
3) Elacestrant monotherapy
4) Everolimus + fulvestrant
🤔What 2L Tx would you offer a 45yo♀️w/ ER+/HER2- mBC and an AKT mutation on 🧪liquid biopsy after progression at cycle 47 of ribociclib ➕ AI/OFS❓
1) Capecitabine monotherapy
2) Capivasertib + fulvestrant
3) Elacestrant monotherapy
4) Everolimus + fulvestrant
October 22, 2025 at 1:25 AM
#PostTest Q1️⃣ #TumorBoardTuesday
🤔What 2L Tx would you offer a 45yo♀️w/ ER+/HER2- mBC and an AKT mutation on 🧪liquid biopsy after progression at cycle 47 of ribociclib ➕ AI/OFS❓
1) Capecitabine monotherapy
2) Capivasertib + fulvestrant
3) Elacestrant monotherapy
4) Everolimus + fulvestrant
🤔What 2L Tx would you offer a 45yo♀️w/ ER+/HER2- mBC and an AKT mutation on 🧪liquid biopsy after progression at cycle 47 of ribociclib ➕ AI/OFS❓
1) Capecitabine monotherapy
2) Capivasertib + fulvestrant
3) Elacestrant monotherapy
4) Everolimus + fulvestrant
18/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 12🏫
🔊Take home points 🔊:
✅ 🩸Bx recommended at⬆️ on 1L to screen for🧬mutations
✅ 2L options: mPFS 5-11 mos, some with⬆️OS
✅ Optimal sequence unknown, likely depends in part on patient factors
👩🏻🏫Mini Tweetorial 12🏫
🔊Take home points 🔊:
✅ 🩸Bx recommended at⬆️ on 1L to screen for🧬mutations
✅ 2L options: mPFS 5-11 mos, some with⬆️OS
✅ Optimal sequence unknown, likely depends in part on patient factors
October 22, 2025 at 1:09 AM
18/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 12🏫
🔊Take home points 🔊:
✅ 🩸Bx recommended at⬆️ on 1L to screen for🧬mutations
✅ 2L options: mPFS 5-11 mos, some with⬆️OS
✅ Optimal sequence unknown, likely depends in part on patient factors
👩🏻🏫Mini Tweetorial 12🏫
🔊Take home points 🔊:
✅ 🩸Bx recommended at⬆️ on 1L to screen for🧬mutations
✅ 2L options: mPFS 5-11 mos, some with⬆️OS
✅ Optimal sequence unknown, likely depends in part on patient factors
17/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 11🏫
Ongoing HR+/HER2- trials:
2️⃣ TroFuse-011 (NCT06841354)
💊 Sacituzumab tirumotecan vs physician’s choice chemo
💉 Trop-2 directed ADC
👆 Primary endpoints: PFS and OS
www.clinicaltrials.gov/study/NCT068...
👩🏻🏫Mini Tweetorial 11🏫
Ongoing HR+/HER2- trials:
2️⃣ TroFuse-011 (NCT06841354)
💊 Sacituzumab tirumotecan vs physician’s choice chemo
💉 Trop-2 directed ADC
👆 Primary endpoints: PFS and OS
www.clinicaltrials.gov/study/NCT068...
ClinicalTrials.gov
clinicaltrials.gov
October 22, 2025 at 1:08 AM
17/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 11🏫
Ongoing HR+/HER2- trials:
2️⃣ TroFuse-011 (NCT06841354)
💊 Sacituzumab tirumotecan vs physician’s choice chemo
💉 Trop-2 directed ADC
👆 Primary endpoints: PFS and OS
www.clinicaltrials.gov/study/NCT068...
👩🏻🏫Mini Tweetorial 11🏫
Ongoing HR+/HER2- trials:
2️⃣ TroFuse-011 (NCT06841354)
💊 Sacituzumab tirumotecan vs physician’s choice chemo
💉 Trop-2 directed ADC
👆 Primary endpoints: PFS and OS
www.clinicaltrials.gov/study/NCT068...
17/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 11🏫
Ongoing HR+/HER2- trials:
1️⃣ HERTHENA-Breast04 (NCT07060807)
💊 Patritumab deruxtecan (HER3-DXd) vs physician’s choice chemo
💉 ADC of HER3 mAb linked to topoisomerase I payload
👆Primary endpoints: PFS and OS
www.clinicaltrials.gov/study/NCT068...
👩🏻🏫Mini Tweetorial 11🏫
Ongoing HR+/HER2- trials:
1️⃣ HERTHENA-Breast04 (NCT07060807)
💊 Patritumab deruxtecan (HER3-DXd) vs physician’s choice chemo
💉 ADC of HER3 mAb linked to topoisomerase I payload
👆Primary endpoints: PFS and OS
www.clinicaltrials.gov/study/NCT068...
ClinicalTrials.gov
clinicaltrials.gov
October 22, 2025 at 1:08 AM
17/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 11🏫
Ongoing HR+/HER2- trials:
1️⃣ HERTHENA-Breast04 (NCT07060807)
💊 Patritumab deruxtecan (HER3-DXd) vs physician’s choice chemo
💉 ADC of HER3 mAb linked to topoisomerase I payload
👆Primary endpoints: PFS and OS
www.clinicaltrials.gov/study/NCT068...
👩🏻🏫Mini Tweetorial 11🏫
Ongoing HR+/HER2- trials:
1️⃣ HERTHENA-Breast04 (NCT07060807)
💊 Patritumab deruxtecan (HER3-DXd) vs physician’s choice chemo
💉 ADC of HER3 mAb linked to topoisomerase I payload
👆Primary endpoints: PFS and OS
www.clinicaltrials.gov/study/NCT068...
16/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 10🏫
DESTINY-Breast04
⬆️ mPFS 10.1 months in ER+/HER-low with T-DXd vs mPFS 5.4 doc’s choice
⬆️ mOS 23.9mon in ER+/HER2-low vs mOS 17.5 doc’s choice
📎https://www.nejm.org/doi/full/10.1056/NEJMoa2203690
👩🏻🏫Mini Tweetorial 10🏫
DESTINY-Breast04
⬆️ mPFS 10.1 months in ER+/HER-low with T-DXd vs mPFS 5.4 doc’s choice
⬆️ mOS 23.9mon in ER+/HER2-low vs mOS 17.5 doc’s choice
📎https://www.nejm.org/doi/full/10.1056/NEJMoa2203690
Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer | NEJM
Among breast cancers without human epidermal growth factor receptor 2 (HER2) amplification, overexpression, or both, a large proportion express low levels of HER2 that may be targetable. Currently ...
www.nejm.org
October 22, 2025 at 1:06 AM
16/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 10🏫
DESTINY-Breast04
⬆️ mPFS 10.1 months in ER+/HER-low with T-DXd vs mPFS 5.4 doc’s choice
⬆️ mOS 23.9mon in ER+/HER2-low vs mOS 17.5 doc’s choice
📎https://www.nejm.org/doi/full/10.1056/NEJMoa2203690
👩🏻🏫Mini Tweetorial 10🏫
DESTINY-Breast04
⬆️ mPFS 10.1 months in ER+/HER-low with T-DXd vs mPFS 5.4 doc’s choice
⬆️ mOS 23.9mon in ER+/HER2-low vs mOS 17.5 doc’s choice
📎https://www.nejm.org/doi/full/10.1056/NEJMoa2203690
16/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 10🏫
DESTINY-Breast04
👩🦳 2L mBC HER2- low
✅ Both ER+ and ER-; HER2-low
➡️IHC1+ = 58% & IHC2+ = 42%
💊 Trastuzumab deruxtecan (T-DXd) v physician’s choice (Cape, eribulin, Gem, paclitaxel or nab-paclitaxel)
💊 T-DXd: ADC of humanized anti-HER2 mAb🔗to topo I⛔
👩🏻🏫Mini Tweetorial 10🏫
DESTINY-Breast04
👩🦳 2L mBC HER2- low
✅ Both ER+ and ER-; HER2-low
➡️IHC1+ = 58% & IHC2+ = 42%
💊 Trastuzumab deruxtecan (T-DXd) v physician’s choice (Cape, eribulin, Gem, paclitaxel or nab-paclitaxel)
💊 T-DXd: ADC of humanized anti-HER2 mAb🔗to topo I⛔
October 22, 2025 at 1:06 AM
16/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 10🏫
DESTINY-Breast04
👩🦳 2L mBC HER2- low
✅ Both ER+ and ER-; HER2-low
➡️IHC1+ = 58% & IHC2+ = 42%
💊 Trastuzumab deruxtecan (T-DXd) v physician’s choice (Cape, eribulin, Gem, paclitaxel or nab-paclitaxel)
💊 T-DXd: ADC of humanized anti-HER2 mAb🔗to topo I⛔
👩🏻🏫Mini Tweetorial 10🏫
DESTINY-Breast04
👩🦳 2L mBC HER2- low
✅ Both ER+ and ER-; HER2-low
➡️IHC1+ = 58% & IHC2+ = 42%
💊 Trastuzumab deruxtecan (T-DXd) v physician’s choice (Cape, eribulin, Gem, paclitaxel or nab-paclitaxel)
💊 T-DXd: ADC of humanized anti-HER2 mAb🔗to topo I⛔
15/18 #TumorBoardTuesday
What is HER2 low mBC❓
👉 HER2 IHC 1+ or IHC 2+ with ⛔FISH
🔬Recent review➡️among all Pts 35% are HER2-low
🔎HR+ Pts, 40% are HER2-low
🔎HR- Pts, 23% are HER2-low
🚫Clinical data suggest probably not a separate clinical subtype but data is immature
📎 www.nejm.org/doi/full/10....
What is HER2 low mBC❓
👉 HER2 IHC 1+ or IHC 2+ with ⛔FISH
🔬Recent review➡️among all Pts 35% are HER2-low
🔎HR+ Pts, 40% are HER2-low
🔎HR- Pts, 23% are HER2-low
🚫Clinical data suggest probably not a separate clinical subtype but data is immature
📎 www.nejm.org/doi/full/10....
Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer | NEJM
Among breast cancers without human epidermal growth factor receptor 2 (HER2) amplification, overexpression, or both, a large proportion express low levels of HER2 that may be targetable. Currently ...
www.nejm.org
October 22, 2025 at 1:03 AM
15/18 #TumorBoardTuesday
What is HER2 low mBC❓
👉 HER2 IHC 1+ or IHC 2+ with ⛔FISH
🔬Recent review➡️among all Pts 35% are HER2-low
🔎HR+ Pts, 40% are HER2-low
🔎HR- Pts, 23% are HER2-low
🚫Clinical data suggest probably not a separate clinical subtype but data is immature
📎 www.nejm.org/doi/full/10....
What is HER2 low mBC❓
👉 HER2 IHC 1+ or IHC 2+ with ⛔FISH
🔬Recent review➡️among all Pts 35% are HER2-low
🔎HR+ Pts, 40% are HER2-low
🔎HR- Pts, 23% are HER2-low
🚫Clinical data suggest probably not a separate clinical subtype but data is immature
📎 www.nejm.org/doi/full/10....
15/18 #TumorBoardTuesday
⏭️ Moving on to Case 3…
#TumorBoardTuesday #OncTwitter Case 3
👩🦳 67 y.o. postmenopausal female
💉 Metastatic HR+, “HER2 low” BC to bone, liver
💊 Progressed on 1L CDK4/6i + ET within 4 months of starting therapy
🧪 No BRCA mutations
⏭️ Moving on to Case 3…
#TumorBoardTuesday #OncTwitter Case 3
👩🦳 67 y.o. postmenopausal female
💉 Metastatic HR+, “HER2 low” BC to bone, liver
💊 Progressed on 1L CDK4/6i + ET within 4 months of starting therapy
🧪 No BRCA mutations
October 22, 2025 at 1:03 AM
15/18 #TumorBoardTuesday
⏭️ Moving on to Case 3…
#TumorBoardTuesday #OncTwitter Case 3
👩🦳 67 y.o. postmenopausal female
💉 Metastatic HR+, “HER2 low” BC to bone, liver
💊 Progressed on 1L CDK4/6i + ET within 4 months of starting therapy
🧪 No BRCA mutations
⏭️ Moving on to Case 3…
#TumorBoardTuesday #OncTwitter Case 3
👩🦳 67 y.o. postmenopausal female
💉 Metastatic HR+, “HER2 low” BC to bone, liver
💊 Progressed on 1L CDK4/6i + ET within 4 months of starting therapy
🧪 No BRCA mutations
14/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 9🏫
evERA study
🥇 Reported that evERA met primary endpoint of PFS in ITT and ESR1 mutated patients
🔊 To be presented at upcoming meeting - #StayTuned
📎https://ascopubs.org/doi/pdf/10.1200/JCO.2023.41.16_suppl.TPS1119
👩🏻🏫Mini Tweetorial 9🏫
evERA study
🥇 Reported that evERA met primary endpoint of PFS in ITT and ESR1 mutated patients
🔊 To be presented at upcoming meeting - #StayTuned
📎https://ascopubs.org/doi/pdf/10.1200/JCO.2023.41.16_suppl.TPS1119
evERA Breast Cancer (BC): Phase III study of giredestrant + everolimus vs exemestane + everolimus in patients (pts) with estrogen receptor-positive, HER2-negative locally advanced or metastatic BC (ER...
TPS1119Background: Endocrine therapy (ET) + a cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) is the
standard of care in pts with ER+, HER2– mBC in the first-line setting. Fulvestrant
± a CDK4/6i, and...
ascopubs.org
October 22, 2025 at 1:00 AM
14/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 9🏫
evERA study
🥇 Reported that evERA met primary endpoint of PFS in ITT and ESR1 mutated patients
🔊 To be presented at upcoming meeting - #StayTuned
📎https://ascopubs.org/doi/pdf/10.1200/JCO.2023.41.16_suppl.TPS1119
👩🏻🏫Mini Tweetorial 9🏫
evERA study
🥇 Reported that evERA met primary endpoint of PFS in ITT and ESR1 mutated patients
🔊 To be presented at upcoming meeting - #StayTuned
📎https://ascopubs.org/doi/pdf/10.1200/JCO.2023.41.16_suppl.TPS1119
14/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 9🏫
📰 Breaking news! 🔊 evERA study
🔎 Phase III, randomized trial (NCT05306340)
👩🦳 mBC HR+/HER2-
✅ Previous tx w/CDK4/6i+ET
💊 Giredestrant (30 mg QD) + Evero vs Exemestane/Evero
💊 Giredestrant: A novel, nonsteroidal oral SERD 🚫 NOT FDA approved as of today
👩🏻🏫Mini Tweetorial 9🏫
📰 Breaking news! 🔊 evERA study
🔎 Phase III, randomized trial (NCT05306340)
👩🦳 mBC HR+/HER2-
✅ Previous tx w/CDK4/6i+ET
💊 Giredestrant (30 mg QD) + Evero vs Exemestane/Evero
💊 Giredestrant: A novel, nonsteroidal oral SERD 🚫 NOT FDA approved as of today
October 22, 2025 at 1:00 AM
14/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 9🏫
📰 Breaking news! 🔊 evERA study
🔎 Phase III, randomized trial (NCT05306340)
👩🦳 mBC HR+/HER2-
✅ Previous tx w/CDK4/6i+ET
💊 Giredestrant (30 mg QD) + Evero vs Exemestane/Evero
💊 Giredestrant: A novel, nonsteroidal oral SERD 🚫 NOT FDA approved as of today
👩🏻🏫Mini Tweetorial 9🏫
📰 Breaking news! 🔊 evERA study
🔎 Phase III, randomized trial (NCT05306340)
👩🦳 mBC HR+/HER2-
✅ Previous tx w/CDK4/6i+ET
💊 Giredestrant (30 mg QD) + Evero vs Exemestane/Evero
💊 Giredestrant: A novel, nonsteroidal oral SERD 🚫 NOT FDA approved as of today
13/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 8🏫
PrE0102
💉Fulvestrant+💊Everolimus vs Fulvestrant/Placebo
⬆️ mPFS 10.3 months fulvestrant + everolimus vs 5.1 fulvestrant alone
👄 Mucositis common → steroid mouth rinse (SWISH study for prophylaxis)
📎https://pubmed.ncbi.nlm.nih.gov/29664714/
👩🏻🏫Mini Tweetorial 8🏫
PrE0102
💉Fulvestrant+💊Everolimus vs Fulvestrant/Placebo
⬆️ mPFS 10.3 months fulvestrant + everolimus vs 5.1 fulvestrant alone
👄 Mucositis common → steroid mouth rinse (SWISH study for prophylaxis)
📎https://pubmed.ncbi.nlm.nih.gov/29664714/
Randomized Phase II Trial of Fulvestrant Plus Everolimus or Placebo in Postmenopausal Women With Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer R...
Purpose The mammalian target of rapamycin inhibitor everolimus targets aberrant signaling through the PI3K/AKT/mammalian target of rapamycin pathway, a mechanism of resistance to anti-estrogen therapy...
pubmed.ncbi.nlm.nih.gov
October 22, 2025 at 12:57 AM
13/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 8🏫
PrE0102
💉Fulvestrant+💊Everolimus vs Fulvestrant/Placebo
⬆️ mPFS 10.3 months fulvestrant + everolimus vs 5.1 fulvestrant alone
👄 Mucositis common → steroid mouth rinse (SWISH study for prophylaxis)
📎https://pubmed.ncbi.nlm.nih.gov/29664714/
👩🏻🏫Mini Tweetorial 8🏫
PrE0102
💉Fulvestrant+💊Everolimus vs Fulvestrant/Placebo
⬆️ mPFS 10.3 months fulvestrant + everolimus vs 5.1 fulvestrant alone
👄 Mucositis common → steroid mouth rinse (SWISH study for prophylaxis)
📎https://pubmed.ncbi.nlm.nih.gov/29664714/
13/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 8🏫
PrE0102: An oldie by a goodie
👩🦳 2L metastatic AI-resistant, HR+/HER2-
✅ Prior ET and < 1 chemo
💉 Fulvestrant + 💊 Everolimus (10mg daily; mTOR inhibtor) vs Fulvestrant/Placebo
👩🏻🏫Mini Tweetorial 8🏫
PrE0102: An oldie by a goodie
👩🦳 2L metastatic AI-resistant, HR+/HER2-
✅ Prior ET and < 1 chemo
💉 Fulvestrant + 💊 Everolimus (10mg daily; mTOR inhibtor) vs Fulvestrant/Placebo
Randomized Phase II Trial of Fulvestrant Plus Everolimus or Placebo in Postmenopausal Women With Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer R...
Purpose The mammalian target of rapamycin inhibitor everolimus targets aberrant signaling through the PI3K/AKT/mammalian target of rapamycin pathway, a mechanism of resistance to anti-estrogen therapy...
pubmed.ncbi.nlm.nih.gov
October 22, 2025 at 12:57 AM
13/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 8🏫
PrE0102: An oldie by a goodie
👩🦳 2L metastatic AI-resistant, HR+/HER2-
✅ Prior ET and < 1 chemo
💉 Fulvestrant + 💊 Everolimus (10mg daily; mTOR inhibtor) vs Fulvestrant/Placebo
👩🏻🏫Mini Tweetorial 8🏫
PrE0102: An oldie by a goodie
👩🦳 2L metastatic AI-resistant, HR+/HER2-
✅ Prior ET and < 1 chemo
💉 Fulvestrant + 💊 Everolimus (10mg daily; mTOR inhibtor) vs Fulvestrant/Placebo
11/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 6🏫
EMERALD
👩🦳2L metastatic HR+/HER2- received 💊 Elacestrant 400mg daily vs 💉fulvestrant or 💊AI
🤢 Most common AE: nausea and vomiting
📎https://ascopubs.org/doi/10.1200/JCO.22.00338?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
👩🏻🏫Mini Tweetorial 6🏫
EMERALD
👩🦳2L metastatic HR+/HER2- received 💊 Elacestrant 400mg daily vs 💉fulvestrant or 💊AI
🤢 Most common AE: nausea and vomiting
📎https://ascopubs.org/doi/10.1200/JCO.22.00338?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
ASCO Publications
ascopubs.org
October 22, 2025 at 12:54 AM
11/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 6🏫
EMERALD
👩🦳2L metastatic HR+/HER2- received 💊 Elacestrant 400mg daily vs 💉fulvestrant or 💊AI
🤢 Most common AE: nausea and vomiting
📎https://ascopubs.org/doi/10.1200/JCO.22.00338?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
👩🏻🏫Mini Tweetorial 6🏫
EMERALD
👩🦳2L metastatic HR+/HER2- received 💊 Elacestrant 400mg daily vs 💉fulvestrant or 💊AI
🤢 Most common AE: nausea and vomiting
📎https://ascopubs.org/doi/10.1200/JCO.22.00338?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
12/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 7🏫
EMBER-3
⬆️ PFS in ESR1m→ 5.5 mon Imlunestrant vs 3.8 mon ET SOC vs 9.4 mon Imlunestrant + Abemaciclib
❓🙋FDA Approved Sept 2025 Imlunestrant monotherapy ONLY [combination not submitted to FDA]
👩🏻🏫Mini Tweetorial 7🏫
EMBER-3
⬆️ PFS in ESR1m→ 5.5 mon Imlunestrant vs 3.8 mon ET SOC vs 9.4 mon Imlunestrant + Abemaciclib
❓🙋FDA Approved Sept 2025 Imlunestrant monotherapy ONLY [combination not submitted to FDA]
Imlunestrant with or without Abemaciclib in Advanced Breast Cancer | NEJM
Imlunestrant is a next-generation, brain-penetrant, oral selective estrogen-receptor (ER) degrader that delivers continuous ER inhibition, even in cancers with mutations in the gene encoding ERα (E...
www.nejm.org
October 22, 2025 at 12:54 AM
12/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 7🏫
EMBER-3
⬆️ PFS in ESR1m→ 5.5 mon Imlunestrant vs 3.8 mon ET SOC vs 9.4 mon Imlunestrant + Abemaciclib
❓🙋FDA Approved Sept 2025 Imlunestrant monotherapy ONLY [combination not submitted to FDA]
👩🏻🏫Mini Tweetorial 7🏫
EMBER-3
⬆️ PFS in ESR1m→ 5.5 mon Imlunestrant vs 3.8 mon ET SOC vs 9.4 mon Imlunestrant + Abemaciclib
❓🙋FDA Approved Sept 2025 Imlunestrant monotherapy ONLY [combination not submitted to FDA]
12/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 7🏫
EMBER-3
👩🦳 2L me HR+/HER2-
💊 Imlunestrant, next gen oral SERD with 🧠CNS activity
✅ 1-2 prior ET+/-CDK4/6i [recurrence <12mo or on adj CDK4/6i/AI or PD on 1L CDK4/6i/ET]
📝 💊 Imlunestrant 400mg QD vs 💊SOC [fulvestrant or exemestane] vs💊 Imlunestrant+Abema
👩🏻🏫Mini Tweetorial 7🏫
EMBER-3
👩🦳 2L me HR+/HER2-
💊 Imlunestrant, next gen oral SERD with 🧠CNS activity
✅ 1-2 prior ET+/-CDK4/6i [recurrence <12mo or on adj CDK4/6i/AI or PD on 1L CDK4/6i/ET]
📝 💊 Imlunestrant 400mg QD vs 💊SOC [fulvestrant or exemestane] vs💊 Imlunestrant+Abema
October 22, 2025 at 12:54 AM
12/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 7🏫
EMBER-3
👩🦳 2L me HR+/HER2-
💊 Imlunestrant, next gen oral SERD with 🧠CNS activity
✅ 1-2 prior ET+/-CDK4/6i [recurrence <12mo or on adj CDK4/6i/AI or PD on 1L CDK4/6i/ET]
📝 💊 Imlunestrant 400mg QD vs 💊SOC [fulvestrant or exemestane] vs💊 Imlunestrant+Abema
👩🏻🏫Mini Tweetorial 7🏫
EMBER-3
👩🦳 2L me HR+/HER2-
💊 Imlunestrant, next gen oral SERD with 🧠CNS activity
✅ 1-2 prior ET+/-CDK4/6i [recurrence <12mo or on adj CDK4/6i/AI or PD on 1L CDK4/6i/ET]
📝 💊 Imlunestrant 400mg QD vs 💊SOC [fulvestrant or exemestane] vs💊 Imlunestrant+Abema
Reposted by Tumor Board Tuesday
#tumorboardtuesday
🤔Hmmm....much more rapid disease progression on the CDK4/6🚫+AI - does this portend for a worse prognosis in subsequent lines of therapy❓
🤔Hmmm....much more rapid disease progression on the CDK4/6🚫+AI - does this portend for a worse prognosis in subsequent lines of therapy❓
October 22, 2025 at 12:48 AM
#tumorboardtuesday
🤔Hmmm....much more rapid disease progression on the CDK4/6🚫+AI - does this portend for a worse prognosis in subsequent lines of therapy❓
🤔Hmmm....much more rapid disease progression on the CDK4/6🚫+AI - does this portend for a worse prognosis in subsequent lines of therapy❓
Reposted by Tumor Board Tuesday
#tumorboardtuesday
Any subtle differences in outcomes based on the specific mutation identified
AKT vs. PTEN vs. PIK3CA❓
Any subtle differences in outcomes based on the specific mutation identified
AKT vs. PTEN vs. PIK3CA❓
October 22, 2025 at 12:29 AM
#tumorboardtuesday
Any subtle differences in outcomes based on the specific mutation identified
AKT vs. PTEN vs. PIK3CA❓
Any subtle differences in outcomes based on the specific mutation identified
AKT vs. PTEN vs. PIK3CA❓
11/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 6🏫
⬆️ Elacestrant benefited all subgroups including: 🦴only, 🫁 visceral mets, > 3 mets
⬆️ Elacestrant benefited all🧬subgroups: ✔️ESR1+PIK3CA, ✔️ESR1+TP53, ✔️ESR1+HER2-low
🤢 Most common AE: N/V
👩🏻🏫Mini Tweetorial 6🏫
⬆️ Elacestrant benefited all subgroups including: 🦴only, 🫁 visceral mets, > 3 mets
⬆️ Elacestrant benefited all🧬subgroups: ✔️ESR1+PIK3CA, ✔️ESR1+TP53, ✔️ESR1+HER2-low
🤢 Most common AE: N/V
ASCO Publications
ascopubs.org
October 22, 2025 at 12:45 AM
11/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 6🏫
⬆️ Elacestrant benefited all subgroups including: 🦴only, 🫁 visceral mets, > 3 mets
⬆️ Elacestrant benefited all🧬subgroups: ✔️ESR1+PIK3CA, ✔️ESR1+TP53, ✔️ESR1+HER2-low
🤢 Most common AE: N/V
👩🏻🏫Mini Tweetorial 6🏫
⬆️ Elacestrant benefited all subgroups including: 🦴only, 🫁 visceral mets, > 3 mets
⬆️ Elacestrant benefited all🧬subgroups: ✔️ESR1+PIK3CA, ✔️ESR1+TP53, ✔️ESR1+HER2-low
🤢 Most common AE: N/V
11/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 6🏫
EMERALD
👩🦳 2L metastatic HR+/HER2- received 💊 Elacestrant, an oral selective ER Degrader (SERD)
✅ 1-2 prior ET including CDK4/6i and < 1 chemo
💊 Elacestrant 400mg daily vs 💉fulvestrant or 💊AI
⬆️⬆️ PFS for prior💊 CDK4/6i > 12 mon with ESR1 mutated tumors
👩🏻🏫Mini Tweetorial 6🏫
EMERALD
👩🦳 2L metastatic HR+/HER2- received 💊 Elacestrant, an oral selective ER Degrader (SERD)
✅ 1-2 prior ET including CDK4/6i and < 1 chemo
💊 Elacestrant 400mg daily vs 💉fulvestrant or 💊AI
⬆️⬆️ PFS for prior💊 CDK4/6i > 12 mon with ESR1 mutated tumors
October 22, 2025 at 12:45 AM
11/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 6🏫
EMERALD
👩🦳 2L metastatic HR+/HER2- received 💊 Elacestrant, an oral selective ER Degrader (SERD)
✅ 1-2 prior ET including CDK4/6i and < 1 chemo
💊 Elacestrant 400mg daily vs 💉fulvestrant or 💊AI
⬆️⬆️ PFS for prior💊 CDK4/6i > 12 mon with ESR1 mutated tumors
👩🏻🏫Mini Tweetorial 6🏫
EMERALD
👩🦳 2L metastatic HR+/HER2- received 💊 Elacestrant, an oral selective ER Degrader (SERD)
✅ 1-2 prior ET including CDK4/6i and < 1 chemo
💊 Elacestrant 400mg daily vs 💉fulvestrant or 💊AI
⬆️⬆️ PFS for prior💊 CDK4/6i > 12 mon with ESR1 mutated tumors
10/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 5🏫
👉 Recurred on adjuvant endocrine tx
👉 Recurred <2y after adjuvant endocrine tx
👉 ⬆️Dz<6mos of starting 1L mBC tx
👉 ⬆️Dz after any duration of >=2nd line of ET-based therapy
👉 Known ESR1 mutation [now have 2 Rx for ESR1m → elacestrant or imlunestrant]
👩🏻🏫Mini Tweetorial 5🏫
👉 Recurred on adjuvant endocrine tx
👉 Recurred <2y after adjuvant endocrine tx
👉 ⬆️Dz<6mos of starting 1L mBC tx
👉 ⬆️Dz after any duration of >=2nd line of ET-based therapy
👉 Known ESR1 mutation [now have 2 Rx for ESR1m → elacestrant or imlunestrant]
October 22, 2025 at 12:42 AM
10/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 5🏫
👉 Recurred on adjuvant endocrine tx
👉 Recurred <2y after adjuvant endocrine tx
👉 ⬆️Dz<6mos of starting 1L mBC tx
👉 ⬆️Dz after any duration of >=2nd line of ET-based therapy
👉 Known ESR1 mutation [now have 2 Rx for ESR1m → elacestrant or imlunestrant]
👩🏻🏫Mini Tweetorial 5🏫
👉 Recurred on adjuvant endocrine tx
👉 Recurred <2y after adjuvant endocrine tx
👉 ⬆️Dz<6mos of starting 1L mBC tx
👉 ⬆️Dz after any duration of >=2nd line of ET-based therapy
👉 Known ESR1 mutation [now have 2 Rx for ESR1m → elacestrant or imlunestrant]
10/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 5🏫
🤔When is a patient considered to be “endocrine resistant”?
Per Advanced Breast Cancer International Consensus Guidelines,
Link to Guidelines: www.thebreastonline.com/article/S096...
👩🏻🏫Mini Tweetorial 5🏫
🤔When is a patient considered to be “endocrine resistant”?
Per Advanced Breast Cancer International Consensus Guidelines,
Link to Guidelines: www.thebreastonline.com/article/S096...
6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7)
This manuscript describes the Advanced Breast Cancer (ABC) international consensus
guidelines updated at the last two ABC international consensus conferences (ABC 6
in 2021, virtual, and ABC 7 in 2023...
www.thebreastonline.com
October 22, 2025 at 12:42 AM
10/18 #TumorBoardTuesday
👩🏻🏫Mini Tweetorial 5🏫
🤔When is a patient considered to be “endocrine resistant”?
Per Advanced Breast Cancer International Consensus Guidelines,
Link to Guidelines: www.thebreastonline.com/article/S096...
👩🏻🏫Mini Tweetorial 5🏫
🤔When is a patient considered to be “endocrine resistant”?
Per Advanced Breast Cancer International Consensus Guidelines,
Link to Guidelines: www.thebreastonline.com/article/S096...
9/18 #TumorBoardTuesday
⏭️ Case 2
#TumorBoardTuesday #OncTwitter Case 2
👩🦳 62 y.o. postmenopausal female
💉 mBC to the🫁, ER 70%, PR 85%, HER2⛔[IHC 1] 🩻 confirmed⬆️Dz on 1L ribo/letrozole at C7
🏃♀️ ECOG PS 1. No co-morbidities.
⛔ Normal vital signs, labs
🩸Liquid Biopsy shows ESR1 mutation, TMB-High
⏭️ Case 2
#TumorBoardTuesday #OncTwitter Case 2
👩🦳 62 y.o. postmenopausal female
💉 mBC to the🫁, ER 70%, PR 85%, HER2⛔[IHC 1] 🩻 confirmed⬆️Dz on 1L ribo/letrozole at C7
🏃♀️ ECOG PS 1. No co-morbidities.
⛔ Normal vital signs, labs
🩸Liquid Biopsy shows ESR1 mutation, TMB-High
October 22, 2025 at 12:40 AM
9/18 #TumorBoardTuesday
⏭️ Case 2
#TumorBoardTuesday #OncTwitter Case 2
👩🦳 62 y.o. postmenopausal female
💉 mBC to the🫁, ER 70%, PR 85%, HER2⛔[IHC 1] 🩻 confirmed⬆️Dz on 1L ribo/letrozole at C7
🏃♀️ ECOG PS 1. No co-morbidities.
⛔ Normal vital signs, labs
🩸Liquid Biopsy shows ESR1 mutation, TMB-High
⏭️ Case 2
#TumorBoardTuesday #OncTwitter Case 2
👩🦳 62 y.o. postmenopausal female
💉 mBC to the🫁, ER 70%, PR 85%, HER2⛔[IHC 1] 🩻 confirmed⬆️Dz on 1L ribo/letrozole at C7
🏃♀️ ECOG PS 1. No co-morbidities.
⛔ Normal vital signs, labs
🩸Liquid Biopsy shows ESR1 mutation, TMB-High
8/18 #TumorBoardTuesday
Back to our case🔎
👉 Everolimus + fulvestrant is not favored given the more targeted approach with Capivasterib for the PIK3CA mutation
✅ Tolerated therapy well with mild rash at start of treatment that resolved with antihistamines
Back to our case🔎
👉 Everolimus + fulvestrant is not favored given the more targeted approach with Capivasterib for the PIK3CA mutation
✅ Tolerated therapy well with mild rash at start of treatment that resolved with antihistamines
October 22, 2025 at 12:38 AM
8/18 #TumorBoardTuesday
Back to our case🔎
👉 Everolimus + fulvestrant is not favored given the more targeted approach with Capivasterib for the PIK3CA mutation
✅ Tolerated therapy well with mild rash at start of treatment that resolved with antihistamines
Back to our case🔎
👉 Everolimus + fulvestrant is not favored given the more targeted approach with Capivasterib for the PIK3CA mutation
✅ Tolerated therapy well with mild rash at start of treatment that resolved with antihistamines