Kelly E. McCann, MD, PhD

Kelly E. McCann, MD, PhD, discusses findings from the VIKTORIA-1 trial of gedatolisib-based regimens in hormone receptor–positive advanced breast cancer.

Kelly McCann, MD, PhD, discusses the relevance of patient preferences during treatment decision-making for patients with HER2-positive breast cancer.

Panelists discuss how the field has made exciting strides, with oral selective estrogen receptor degraders (SERDs) likely moving into early-stage disease and the need for alternative antibody-drug conjugate (ADC) payloads beyond topoisomerase I inhibitors to overcome resistance mechanisms.

Panelists discuss how HER2 testing challenges for identifying HER2-low and -ultralow expression require coordination with pathologists and may involve

Kelly E. McCann, MD, PhD, details the current standard of care and novel approaches for the treatment of ER-positive, HER2-negative advanced breast cancer.

Panelists discuss how they approach sequencing decisions for patients with hormone receptor–positive, HER2- low/ultralow disease, emphasizing selective use of trastuzumab deruxtecan in first-line chemotherapy settings while considering quality-of-life factors.

Panelists discuss how subgroup analyses from DESTINY-Breast06 show trastuzumab deruxtecan benefits across different mutation groups, with particularly strong responses in patients with BRCA1/2-mutated disease due to the topoisomerase I inhibitor payload.

Panelists discuss how treatment options for HER2-low and HER2-ultralow metastatic breast cancer include trastuzumab deruxtecan (T-DXd) and sacituzumab govitecan, with sequencing becoming a key consideration.

Panelists discuss how to manage toxicities associated with datopotamab deruxtecan, particularly ocular toxicity and stomatitis, using prophylactic measures such as steroid mouthwash and eye drops.

Panelists discuss how datopotamab deruxtecan from the TROPHY-PD-01 trial compares with sacituzumab govitecan, highlighting different toxicity profiles and the challenge of sequencing multiple antibody-drug conjugates (ADCs) with the same TROP2 payload.

Panelists discuss how the TROPiCS-02 trial established sacituzumab govitecan for hormone receptor–positive, HER2-negative metastatic breast cancer and how it influences sequencing decisions with other antibody-drug conjugates (ADCs) such as trastuzumab deruxtecan.

Panelists discuss how they decide when to transition from endocrine-based therapies to antibody-drug conjugates, considering factors such as endocrine sensitivity, disease burden, and pace of progression.

Panelists discuss how to approach decision-making among PI3K/AKT pathway inhibitors (capivasertib, alpelisib, everolimus) based on mutation status, toxicity profiles, and dosing schedules in the second-line setting.

Kelly McCann, MD, PhD, discusses the need to reach consensus on the potential role of vepdegestrant for ER-positive, HER2-negative advanced breast cancer.

Panelists discuss how upcoming oral selective estrogen receptor degraders (SERDs; eg, camasertinib, imlunestrant, and giredestrant) are showing efficacy primarily in populations with ESR1 mutations and are all well-tolerated oral agents that will likely receive approvals.

Panelists discuss how elacestrant from the EMERALD trial is being incorporated into practice based on ESR1 mutation status and duration of prior CDK4/6 inhibitor therapy, with combination approaches being explored in the ELEVATE trial.

Panelists discuss how the SERENA-6 trial design uses circulating tumor DNA (ctDNA) monitoring to detect ESR1 mutations and switch patients from aromatase inhibitors to oral selective estrogen receptor degraders (SERDs) such as camasertinib while continuing CDK4/6 inhibitors.

Panelists discuss how they will review the latest updates in hormone receptor–positive, HER2-negative, and HER2-low metastatic breast cancer, focusing on oral selective estrogen receptor degraders (SERDs), targeted therapies, and antibody-drug conjugates presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting.

Panelists discuss how emerging developments in HER2-positive (HER2+) breast cancer treatment, including novel antibody-drug conjugates, bispecific antibodies, and cytotoxic-sparing regimens for hormone receptor+ (HR+)/HER2+ disease, are creating exciting new options for patients.

Panelists discuss how they approach treatment beyond third-line therapy for HER2-positive (HER2+) metastatic breast cancer, considering factors such as prior therapies, residual toxicities, and patient preferences when selecting from multiple options.

Panelists discuss how they manage adverse effects of tucatinib-based therapy, particularly focusing on diarrhea and palmar-plantar erythrodysesthesia from capecitabine, with practical dosing strategies to improve tolerability.

Kelly E. McCann, MD, PhD, discusses the biologic heterogeneity within HER2-positive breast cancer and highlights the clinical implications of HR status in this disease subset.

Panelists discuss how treatment decisions in later-line settings should incorporate clinical trials, patient preferences regarding quality of life, medication scheduling, financial considerations, and previous adverse effect experiences, while also addressing special considerations for brain metastases.

Panelists discuss how the HER2CLIMB-02 and HER2CLIMB-05 trials might impact treatment sequencing, with particular interest in using tucatinib earlier in treatment to potentially prevent brain metastases.

Panelists discuss how National Comprehensive Cancer Network (NCCN) guidelines inform third-line treatment options for HER2-positive (HER2+) metastatic breast cancer, with particular focus on the HER2CLIMB regimen (tucatinib, capecitabine, and trastuzumab) for patients with brain metastases.

Panelists discuss how fourth-line treatment options include margetuximab (which interacts better with the immune system), neratinib-capecitabine (an irreversible pan-HER inhibitor), and antibody-drug conjugates (ADCs) with different payloads, though toxicity profiles must be considered.

Panelists discuss how third-line treatment options after T-DXd progression include T-DM1 and the HER2CLIMB regimen (tucatinib-capecitabine-trastuzumab), with consideration of brain metastases as a key factor in treatment selection.

Panelists discuss how they would approach multiple brain metastases at initial metastatic diagnosis, debating the use of stereotactic radiosurgery vs systemic therapy with agents that cross the blood-brain barrier.

Panelists discuss how they approach the case of a 47-year-old marketing executive with initially low-risk HER2-positive (HER2+) breast cancer who developed brain, liver, lung, and bone metastases shortly after completing adjuvant therapy.

Panelists discuss how the treatment landscape for early HER2-positive metastatic breast cancer has evolved, with taxane-pertuzumab-trastuzumab as first-line standard of care and T-DXd supplanting T-DM1 as the preferred second-line treatment.