What are your top takeaways in Breast Cancer from ESMO 2025?

1. ASCENT-03: At ASCO, the results of ASCENT-04 already showed an improvement of PFS (11.2 months vs. 7.8 months) in first-line setting for PD-L1 positive advanced triple negative breast cancer patients treated with sacituzumab plus pembrolizumab compared to chemotherapy plus pembrolizumab. The ASCEN...

In early BC:

• DESTINY-Breast05: TDXd is more effective than T-DM1 in the post-KATHERINE era. However, ILD is increased despite monitoring the patients who received XRT, with two deaths. Thus, I would consider TDXd for those with residual nodal disease, and not for those with only a little disease.
• Mo...

I would include the DESTINY trials, especially DESTINY-Breast05. I think this is practice-changing, and I would start using Enhertu instead of T-DM1 post-neoadjuvant therapy in patients with residual disease. I’m less inclined to change therapy in the neoadjuvant setting per DESTINY-Breast11, given ...

1. VIKTORIA-1/evERA: Novel therapy post-CDK4/6i progression likely new SOC.
2. ASCENT-03/TROPION-Breast02: TROP2 ADCs are now SOC as 1st-line mTNBC.
3. DESTINY-Breast11/DESTINY-Breast05: T-DXd has a place as NAT and post-NAT with RD.

DESTINY-Breast05, DESTINY-Breast11, TROPION-Breast02, and evERA were the four I would think are worth highlighting.

1. DESTINY-Breast09: Meaningful improvement in IDFS for patients with HER2+ residual disease following neoadjuvant therapy. May represent a new standard of care using T-DXd instead of T-DM1. Importantly, there was a reduction in CNS recurrences in the T-DXd arm.
2. TROPION-Breast02 and ASCENT-03: Highlig...

I think I am probably with the majority of people who felt the big data in breast was around DESTINY-Breast05, DESTINY-Breast11, and ASCENT-03. It was a lot of ADC data across different lines, and I felt like, in particular, DB05 could be a big change for high-risk HER2+ disease with residual diseas...