Rebecca A. Shatsky, MD

Early detection of ESR1 mutations in breast cancer enhances treatment strategies, potentially improving patient outcomes and quality of life.

Clinicians explore the differences between EMERALD and EMBER3 trials, focusing on patient characteristics, treatment efficacy, and future therapy roles.

Oral SERDs emerge as a standard treatment for HR-positive, HER2-negative metastatic breast cancer, especially for patients with ESR1 mutations.

Oral SERDs emerge as a standard treatment for HR-positive, HER2-negative metastatic breast cancer, especially for patients with ESR1 mutations.

Experts discuss the impact of biomarkers and treatment duration on decision-making for CDK4/6 inhibitors in breast cancer adjuvant therapy.

Discover effective strategies for managing toxicities in patients using CDK4/6 inhibitors, ensuring adherence and optimal treatment outcomes.

Clinicians explore barriers to adjuvant CDK4/6-inhibitor therapy, emphasizing education and streamlined communication to improve patient outcomes.

Experts discuss advancements in HR-positive breast cancer treatment, focusing on CDK4/6 inhibitors, SERDs, and early intervention strategies.

Experts discuss advancements in HR-positive breast cancer treatment, focusing on CDK4/6 inhibitors, SERDs, and early intervention strategies.

CDK4/6 Inhibition in HR-Positive Breast Cancer: Evolving Standards in Early and Metastatic Care

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

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.

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 the most exciting data and studies presented at the San Antonio Breast Cancer Symposium (SABCS) that show promise for improving outcomes in both HR-positive (HR+) and HER2-negative (HER2–) metastatic breast cancer and early-stage triple-negative breast cancer (TNBC), highlighting how precision medicine has enhanced outcomes and the overall patient experience.

Panelists discuss factors influencing the decision to continue adjuvant immunotherapy for patients achieving pathologic complete response (pCR) with pembrolizumab-containing therapy, weighing the benefits against risks and considering the role of biomarkers. They also explore sequencing decisions for patients with both BRCA mutations and early-stage triple-negative breast cancer (TNBC), focusing on the prioritization of PARP inhibition versus immunotherapy and situations where both may be recommended. Additionally, they discuss approaches to monitoring and managing immune-related adverse events, including baseline screening and ongoing management protocols.

Panelists highlight the KN-522 study and discuss how updated KEYNOTE-522 data influence their selection of patients for pembrolizumab-containing regimens, focusing on factors that guide the decision to recommend immunotherapy and how to approach patients with borderline indications.

Panelists discuss how recent data inform their approach to PARP inhibitor use in the metastatic setting, exploring the role of PARP inhibition for somatic BRCA mutations and strategies for managing PALB2 and other homologous recombination deficiency mutations.

Panelists review the recent OlympiA data presented at the 2024 San Antonio Breast Cancer Symposium (SABCS) and discuss how the findings influence their approach to sequencing adjuvant olaparib with other systemic therapies for breast cancer patients.

Panelists discuss their approach to BRCA testing in early-stage versus metastatic breast cancer patients, highlighting the 2024 American Society of Clinical Oncology (ASCO) guidelines for germline testing and exploring which patients are not tested for BRCA, as well as how they differentiate between germline and somatic testing approaches.