Neil M. Iyengar, MD

Explore the latest insights on CNS metastases treatment, highlighting the effectiveness of T-DXd and local therapies in managing brain cancer.

Exploring the potential of T-DXd in HER2 therapy, including resistance mechanisms and optimal treatment sequencing for better patient outcomes.

Explore the evolving landscape of HER2-targeted therapies and the challenges in selecting effective second-line treatments after T-DXd.

Experts discuss the promising safety and efficacy of T-DXd in treating HER2-positive breast cancer, highlighting improved survival rates and response.

This segment highlights the interim topline efficacy findings from DESTINY Breast09 and explores their potential implications for first-line treatment of HER2 positive metastatic breast cancer. The discussion summarizes progression-free survival signals observed with trastuzumab deruxtecan with or without pertuzumab compared with the historical standard regimen of docetaxel, trastuzumab, and pertuzumab. Panelists emphasize that these results represent an early data readout and should be interpreted cautiously pending peer-reviewed publication, mature follow-up, and formal guideline integration. The conversation focuses on how these findings may challenge existing first-line paradigms by introducing an antibody drug conjugate earlier in the disease course, while reinforcing the importance of contextualizing DB09 within the broader HER2 evidence base. This segment sets the stage for subsequent discussion on safety, durability of benefit, and how emerging data may ultimately influence clinical practice once fully validated.

This opening segment sets the clinical foundation for the program by reviewing how treatment paradigms for HER2 positive metastatic breast cancer have evolved in recent years. The discussion introduces current guideline supported first line standards of care and highlights how the incorporation of antibody drug conjugates has expanded therapeutic possibilities beyond traditional chemotherapy and monoclonal antibody combinations. Panelists reflect on how these advances have reshaped long term disease management by improving response depth and extending disease control for many patients. Attention is also given to real world implementation, with comparison of adoption patterns across academic and community practices. Factors such as familiarity with novel agents, comfort managing ADC and TKI associated toxicities, and access to infusion resources are explored as drivers of variation in first line treatment selection. This segment establishes a practical framework for understanding how evolving evidence translates into everyday clinical decision making for patients with HER2 positive disease.

Panelists discuss how innovative HER2-targeted strategies and precision approaches will define the next era of breast cancer therapy.

Panelists discuss how new trial results from ASCENT-03 and TROPION-Breast02 are shaping next-generation TNBC therapies.

Panelists discuss how molecular characterization and novel agents are redefining the management of TNBC.

Panelists discuss how HER2-low and HER3-directed therapies are expanding precision treatment opportunities in metastatic breast cancer.

Panelists spotlight key trials and drugs to watch in ongoing research in triple-negative breast cancer.

Panelists break down other key triple-negative breast cancer data presented at the 2025 ESMO Congress.

Panelists discuss how newer HER2-targeted therapies show promise for CNS disease control and broader metastatic management.

Panelists discuss how thoughtful sequencing of HER2-targeted agents maximizes benefit and extends survival in metastatic settings.

Panelists discuss findings from the TROPION-Breast02 trial evaluating first-line datopotamab deruxtecan in immunotherapy-ineligible triple-negative breast cancer.

Panelists discuss sequencing considerations as more TROP-2–directed antibody-drug conjugates are evaluated in triple-negative breast cancer.

Panelists discuss how evolving first-line HER2-targeted combinations are improving outcomes and redefining standards in metastatic breast cancer..

Panelists discuss how ADCs are revolutionizing HER2-targeted therapy through precision delivery and improved tolerability across patient subgroups.

Panelists discuss safety considerations for sacituzumab govitecan–based therapy in frontline triple-negative breast cancer.

Panelists highlight findings from the ASCENT-03 trial evaluating sacituzumab govitecan in triple-negative breast cancer ineligible for immunotherapy.

Panelists discuss how new trial data are optimizing early-stage HER2-positive breast cancer treatment through refined, evidence-based regimens.

Panelists discuss how the evolution of HER2 testing and classification has redefined treatment strategies and expanded therapeutic opportunities in breast cancer.

Panelists break down data from the ASCENT-04 trial evaluating sacituzumab govitecan plus pembrolizumab in triple-negative breast cancer.

Panelists discuss the current state of the frontline treatment paradigm for advanced triple-negative breast cancer

Panelists discuss how the continued evolution of HER2-directed therapies, particularly the expanding role of trastuzumab deruxtecan (T-DXd) across different breast cancer settings, has transformed the treatment landscape, while emphasizing the importance of appropriate patient selection, optimal sequencing strategies, and the need for education around early adoption of promising therapies in community practice settings.

Panelists discuss how emerging data from trials such as DESTINY-Breast09, which is evaluating first-line trastuzumab deruxtecan (T-DXd) with or without pertuzumab, could potentially reshape the treatment paradigm for HER2+ metastatic breast cancer (mBC) by establishing new standards for initial therapy and optimal combination approaches.

Panelists discuss how sequential therapy selection for patients with HER2+ breast cancer with progressive brain metastases requires careful consideration of prior treatments, patterns of progression, symptom burden, and available clinical trials, while balancing the need for both systemic disease control and CNS -specific approaches.

Panelists discuss how the DESTINY-Breast12 trial evaluated trastuzumab deruxtecan (T-DXd) in patients with HER2+ metastatic breast cancer (mBC) with brain metastases, demonstrating encouraging intracranial responses and overall survival outcomes while maintaining a manageable safety profile consistent with previous T-DXd studies.

Panelists discuss how treatment selection for patients with HER2+ breast cancer with brain metastases requires careful consideration of factors such as metastatic burden, symptomatology, and prior therapies, typically incorporating both local approaches and systemic agents with CNS activity while accounting for individual patient characteristics such as performance status, comorbidities, and preferences in developing personalized treatment plans.

Panelists discuss how patients with HER2+ breast cancer frequently develop brain metastases, with recent pivotal trials such as HER2CLIMB and DESTINY-Breast03 demonstrating improved intracranial responses with newer agents such as tucatinib, and how trastuzumab deruxtecan leads to evolving standards of care (SOC) that now incorporate these targeted therapies alongside traditional local therapies.