Heather Moore
@HeatherMoore16
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Breast Oncology Pharmacist at Duke Cancer Institute Exercise Enthusiast, Animal Lover, Wolfpack Supporter
Durham, NC
Joined September 2011
Original Article: Sacituzumab Govitecan in Untreated, Advanced Triple-Negative Breast Cancer (ASCENT-03 phase 3 trial) https://t.co/bqrtNPNct5
#Oncology
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This is HUGE. 20 years after the approval of the latest adjuvant ET, a novel SERD may join the adjuvant arena. In the lidERA phase 3 trial, giredestrant significantly improved iDFS vs SoC ET in patients with stage I-III ER+ BC, with a positive OS trend. https://t.co/cFLCT7syxp
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One of the main resistance mechanisms to T-DXd, especially in HER2-low tumors, is HER2 loss — seen in 41% of HER2 1+, 16% of 2+, and 5% of 3+ cases. This occurs because HER2-low tumors are not biologically dependent on HER2 signaling; under HER2-targeted ADC pressure,
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After the provocative editorial by Ian Tannock et al. against the use of adjuvant CDK4/6i ( https://t.co/X10ebcwxiA) a reply in defense of adjuvant CDK4/6i is now out in @JCO_ASCO, showing treatment effect across multiple censoring scenarios 👇🏻 https://t.co/8wB2KR2YtU
@OncoAlert
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Excited to see our new publication! Pooled analysis of trastuzumab deruxtecan retreatment after recovery from grade 1 ILD/pneumonitis in @Annals_Oncology Marked efficacy with reRx post recovery! @oncoalert @cityofhope
annalsofoncology.org
Trastuzumab deruxtecan (T-DXd), an antibody-drug conjugate treatment for multiple solid tumors, carries risk of interstitial lung disease/pneumonitis (ILD). Management guidelines generally mandate...
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Time to rethink brain MRI surveillance in MBC? 📊 ~1 in 4 w/ MBC have silent BM ⚡ Early MRI = smaller lesions, fewer symptoms, ↑chance for SRS 💡 As therapies improve, detecting BM may change outcomes #bcsm @OncoAlert
https://t.co/btz2mCzjt6
thebreastonline.com
Brain metastases (BM) are common in patients with metastatic breast cancer (MBC). Over time, roughly 25–50% of patients with HER2-positive (HER2+) or triple-negative MBC will develop BM [1–8]. BM are...
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The way forward -> sequencing ADCs with different payloads (MMAE, TOPO1, and beyond)
Treatment after EVP in bladder cancer is undefined. Izalontamab brenitecan (HER2/3 TROP2 ADC) has good activity in bladder+lung cancer. A global randomised phase III has started enrolment 👉 Iza Bren alone vs platinum chemo in previously treated pts (including EVP). @OncoAlert
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Mitigation and management of limiting toxicities will be essential as ADCs move up in EBC!
ADCs as magic bullets: we’re not there yet. But we’re on the right track. Fine tuning of dose & schedule, pharmacogenomics, innovative diagnostic tools and novel ADC formats will soon make ADCs safer, enabling for improved outcomes with reduced toxicity. #ESMO25 #ESMOAmbassadors
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#ESMO25 TROPION-Breast02 (Dato-DXd vs CT, 1L PD-(L)1–ineligible mTNBC) Dato-DXd markedly improved outcomes vs chemo — mPFS 10.8 vs 5.6 mo (HR 0.57), ORR 62% vs 29%, with no grade 5 TRAEs and a confirmed OS benefit. I think Dato-DXd is clearly ahead of SG!!👏👏👏
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Practical intervention for de-escalation!
#ESMO25 - Patients with metastatic breast cancer who had received ≥ 2 years of bone modifying agents🦴were randomized to continue standard dosing (Q4W) or de-escalate to Q24W De-escalation preserved physical function without increasing skeletal events @OncoAlert
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Challenging when trial designs do not incorporate current SOC making interpretation difficult!
There is understandable power to 'global' oncology trials, but sponsors need to assure appropriate standards of care are met. In DB-11, > 40% of pts with residual HER2+ BC did not get TDM1, the standard since 2019. It means EFS data are and will be hard to interpret.
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Now for the fun - we are likely to have multiple options in 1L HER-2+ #bcsm. 1L THP->TH + tucatinib (HER2CLIMB-05) 1L THP->TH + AI + palbo (PATINA) 1L TDX-d->+/- maintenance? (DB-09) Desire for maintenance strategy I think remains high (efficacy, QOL, tolerability)!
Breaking: HER2CLIMB-05 Pfizer reports positive Phase 3 results — adding TUKYSA (tucatinib) to trastuzumab + pertuzumab maintenance significantly improves PFS in first-line HER2+ metastatic breast cancer. 🔹 Trial: HER2CLIMB-05 🔹 Setting: 1L maintenance after chemo + HP 🔹
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Happy to share press release from this morning that #HER2CLIMB05 is positive - tucatinib in 1L HER-2+ maintenance improves PFS. Options expanding in this space! #bcsm
https://t.co/OQU6TukmKg
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DB-11 abstract just released. In high-risk (≥T3, N+, or IBC) HER2+ eBC, neoadjuvant T-DXd-THP outperformed ddAC-THP (pCR rate 67% vs 56%, p=0.003), with reduction in cardiotoxicity (LVD 1.9 vs 9%) and low rate of ILD (4.4 vs 5.1%). The last nail in the coffin for anthracyclines.
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One week to #ESMO25. An unprecedented ESMO conference. Seven positive press releases, anticipating the expansion of T-DXd to the curative setting, two Trop2 ADCs reaching first-line mTNBC, 2 novel ET-based combos, adjuvant CDK4/6i improving OS. See you in Berlin! #ESMOAmbassadors
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We have 3 TOPO1 ADCs approved for HR+/HER2- MBC. We will soon have 3 TOPO1 ADCs approved for mTNBC. A 4th TOPO1 ADC (Sac-TMT) is approved in 🇨🇳 & may soon reach 🇺🇸 🇪🇺. No ongoing trial is comparing a sequence of TOPO1 ADCs to a different sequence. Houston, we have a problem.
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Important to compare the rate of crossover once the two trials are presented. It makes all the difference for OS.
Compare the wording on OS from $AZN & $DSKNY on Tropion-Breast02, vs $GILD on Ascent-03. Datroway "stat sig & clinically meaningful" on both PFS & OS, but only "no OS detriment" for Trodelvy
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No better news to start the week. In TROPION-Breast02, 1L datopotamab deruxtecan improved PFS & OS over chemo for IO-ineligible pts with metastatic TNBC. ADCs keep delivering & are rapidly climbing to earlier lines. Hope to see the full results at #ESMO25. https://t.co/Hh0vJ8lhF4
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A 400-mg ribociclib starting dose did not match the efficacy of 600 mg in HR+/ERBB2− advanced breast cancer, but had similar progression-free survival and fewer adverse events. https://t.co/AXrEBQt3xt
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