This week’s Targeted Pulse summarizes key oncology developments reported at the 2025 American Society of Hematology Annual Meeting and Exposition and the San Antonio Breast Cancer Symposium (SABCS).
Reader polls at SABCS highlighted several breast cancer abstracts of clinical interest. In HR+/HER2– early breast cancer, the phase 3 lidERA study showed the oral SERD giredestrant met its primary end point with a statistically significant and clinically meaningful improvement in invasive disease‑free survival versus standard endocrine therapy. The ASCENT‑07 trial in HR+/HER2– metastatic breast cancer did not meet its primary end point of progression‑free survival for sacituzumab govitecan versus chemotherapy. For HER2+ disease, HER2CLIMB‑05 (tucatinib combination) met its primary PFS end point. Safety and quality‑of‑life data from ASCENT‑04 of sacituzumab govitecan plus pembrolizumab in triple‑negative breast cancer will also be presented.
The phase 3 MajesTEC‑3 trial showed that teclistamab plus subcutaneous daratumumab significantly improved outcomes in patients with relapsed/refractory multiple myeloma who had one to three prior therapies. Tec‑Dara reduced the risk of disease progression or death by 83% (median PFS not reached vs 18.1 months) and reduced the risk of death by 54% (36‑month OS rate 83.3% vs 65.0%). The combination produced higher complete response rates (81.8% vs 31.1%) and greater rates of MRD negativity. The safety profile was reported as manageable, supporting the regimen as a potential new standard in earlier lines of R/R multiple myeloma.
The phase 3 ASCENT‑07 trial of sacituzumab govitecan as first‑line chemotherapy after endocrine therapy for HR+/HER2– metastatic breast cancer did not achieve a statistically significant PFS benefit by blinded independent central review; median PFS was 8.3 months in both arms. An early OS trend favoring sacituzumab was observed, but overall survival data remain immature (27% maturity). Grade 3 or higher treatment‑emergent adverse events were more frequent with sacituzumab (72% vs 48%). Sacituzumab govitecan remains established as a post‑chemotherapy option based on TROPiCS‑02 results.
Patient‑reported outcomes from DESTINY‑Breast09 comparing trastuzumab deruxtecan plus pertuzumab with standard‑of‑care taxane, trastuzumab and pertuzumab in first‑line HER2+ advanced breast cancer showed similar maintenance of physical function and comparable control of pain and fatigue. The T‑DXd plus pertuzumab arm had more gastrointestinal events but fewer skin/mucosal symptoms and less extremity swelling. Overall tolerability was reported as similar over time, supporting T‑DXd plus pertuzumab as an alternative first‑line option.
A long‑term exploratory analysis of the phase 3 ALTTO trial favored aromatase inhibitors as adjuvant endocrine therapy for HR+/HER2+ early breast cancer. With a median follow‑up of 9.9 years, 10‑year disease‑free survival was 80.1% with aromatase inhibitors versus 76.5% with SERMs (adjusted HR 0.65). Benefits in DFS and time to distant recurrence were seen across menopausal subgroups without compromising overall survival. In premenopausal patients, aromatase inhibitors with or without ovarian function suppression provided superior 10‑year DFS compared with SERM‑based regimens.
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