Oncology Brothers: Practice-Changing Cancer Discussions ASCO 2025 - Breast Cancer Highlights: INAVO120, SERENA-6, VERITAC-2, DESTINY-Breast09, ASCENT-04
Jun 20, 2025
Join Dr. Erika Hamilton, a medical oncologist from the Sarah Cannon Research Institute, as she shares her expertise on groundbreaking breast cancer research from ASCO 2025. The discussion dives into the INAVO120 trial's survival benefits for specific patient groups, the promising results of SERENA-6 using ctDNA for better therapeutic decisions, and the significant progress shown in DESTINY-Breast09 and ASCENT-04 for treating advanced HER2-positive and triple-negative breast cancers. Explore the future of cancer treatment with these practice-changing insights!
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PI3K Addition Improves Outcomes
- INAVO120 showed PFS more than doubled and an OS gain of ~7 months with inavolisib added to fulvestrant+palbociclib in early-relapsing PIK3CA-mutant HR+ disease.
- Dr. Erika Hamilton emphasized hyperglycemia as a class toxicity to manage despite meaningful survival benefit.
Early ctDNA-Guided Switch Works Short Term
- SERENA-6 used serial ctDNA to detect emerging ESR1 mutations and switching to camizestrant delayed progression compared with continuing AI+CDK.
- Dr. Hamilton warned the PFS2 comparisons are imperfect and longer-term survival and quality-of-life data are needed.
Offer Oral SERD For ESR1-Mutant Second Line
- Use oral SERDs like vepdegestrant for ESR1-mutant patients after prior CDK4/6 exposure based on superior PFS versus fulvestrant.
- Monitor LFTs and fatigue, since gastrointestinal toxicity was low but fatigue occurred in ~27% per Dr. Hamilton.