Podcasts about her2

Our Landmarks of OncoPharm series returns to discuss the CLEOPATRA study, which established docetaxel, trastuzumab, pertuzumab (THP) as a standard first-line regimen for metastatic HER2-amplified breast cancer.

Featuring an interview with Dr Rinath M Jesselsohn, including the following topics: Evaluating first-line treatment of metastatic ER-positive, HER2-positive breast cancer: heredERA Breast Cancer study (0:00) Kuemmel S et al. heredERA Breast Cancer: A phase III, randomized, open-label study evaluating the efficacy and safety of giredestrant plus the fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection in patients with previously untreated HER2-positive, estrogen receptor-positive locally advanced or metastatic breast cancer. BMC Cancer 2024;24(1):641. Abstract  Treatment outcomes with CDK4/6 inhibitors and with elacestrant in real-world studies (4:13) Lloyd MR et al. CDK4/6 inhibitor efficacy in ESR1-mutant metastatic breast cancer. NEJM Evid 2024;3(5). Abstract  Lloyd M et al. Impact of prior treatment, ESR1 mutational (ESR1m) landscape, and co-occurring PI3K pathway status on real-world (RW) elacestrant outcomes in patients (pts) with hormone receptor-positive (HR+)/HER2-negative advanced breast cancer (aBC). San Antonio Breast Cancer Symposium 2024;Abstract PS7-05.  Evaluating the CNS activity of imlunestrant, an oral selective estrogen receptor degrader (SERD) (8:06) VandeKopple M et al. Preclinical characterization of imlunestrant, an oral brain-penetrant selective estrogen receptor degrader with activity in a brain metastasis (BM) model. ESMO Breast 2023;Abstract 41P.  Selective review of trials of oral SERDs in the adjuvant setting (11:27) A study of imlunestrant versus standard endocrine therapy in participants with early breast cancer (EMBER-4). NCT05514054 CME information and select publications

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/QJY865. CME/MOC/NCPD/AAPA credit will be available until May 13, 2026.Navigating the Clinical Integration of TROP2-Targeted ADCs in TNBC and HR+, HER2- Metastatic Breast Cancer: A Customized Learning Journey In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis program has been supported by an independent educational grant from Gilead Sciences, Inc.Disclosure information is available at the beginning of the video presentation.

Featuring an interview with Dr Rinath M Jesselsohn, including the following topics: Imlunestrant with or without abemaciclib in advanced breast cancer: Results of the Phase III EMBER-3 trial (0:00) Jhaveri KL et al. Imlunestrant with or without abemaciclib in advanced breast cancer. N Engl J Med 2025;392(12):1189-202. Abstract  Jhaveri KL et al. Imlunestrant, an oral selective estrogen receptor degrader (SERD), as monotherapy & combined with abemaciclib, for patients with ER+, HER2- advanced breast cancer (ABC), pretreated with endocrine therapy (ET): Results of the Phase 3 EMBER-3 trial. San Antonio Breast Cancer Symposium 2024;Abstract GS1-01. Comprehensive genomic profiling of ESR1, PIK3CA, AKT1 and PTEN in HR-positive, HER2-negative metastatic breast cancer: Prevalence along treatment course and predictive value for endocrine therapy resistance in real-world practice (7:00) Bhave MA et al. Comprehensive genomic profiling of ESR1, PIK3CA, AKT1, and PTEN in HR(+)HER2(-) metastatic breast cancer: Prevalence along treatment course and predictive value for endocrine therapy resistance in real-world practice. Breast Cancer Res Treat 2024;207(3):599-609. Abstract Camizestrant, a next-generation oral selective estrogen receptor degrader (SERD), versus fulvestrant for postmenopausal women with estrogen receptor-positive, HER2-negative advanced breast cancer (SERENA-2): A multi-dose, open-label, randomized, Phase II trial (10:25) Oliveira M et al. Camizestrant, a next-generation oral SERD, versus fulvestrant in post-menopausal women with oestrogen receptor-positive, HER2-negative advanced breast cancer (SERENA-2): A multi-dose, open-label, randomised, phase 2 trial. Lancet Oncol 2024;25(11):1424-39. Abstract Latest on SERDs: An education session at San Antonio Breast Cancer Symposium 2024 (13:57) Jeselsohn RM. Latest on selective estrogen receptor degraders (SERDs). San Antonio Breast Cancer Symposium 2024;Education Session 5. CME information and select publications

This featured podcast includes a discussion with 3 experts on managing patients with hormone receptor–positive/HER2-negative (HR+/HER2–) metastatic breast cancer (mBC) from a satellite symposium held in conjunction with the 42nd Annual Miami Breast Cancer Conference® in March 2025. In observational studies of treatment patterns in older women with mBC, approximately half of the patients were undertreated, and only half received a CDK4/6 inhibitor (CDK4/6i)-based regimen in the first-line setting. Reasons for undertreatment include concerns about the patient's age, perceived frailty, and underlying health issues. Aging is a heterogeneous process; older patients must receive individualized treatment that is not based solely on their age but on a comprehensive assessment that objectively assesses their overall health and ability to tolerate treatment. This program is designed to help clinicians assess the fitness of older patients with HR+/HER2– mBC, review the efficacy and safety of CDK4/6i in this patient population, and individualize treatment decision-making appropriately. Acknowledgment of Educational Grant Support This activity is supported by an educational grant from Pfizer Inc. Today's faculty are: Hope S. Rugo, MD Director, Women's Cancers Program Division Chief, Breast Medical Oncology Professor, Department of Medical Oncology & Therapeutics Research City of Hope Comprehensive Cancer Center Duarte, CA Professor Emeritus, UCSF Disclosures: Grant/Research Support: Ambrx; AstraZeneca; Daiichi Sankyo, Inc; F. Hoffmann-La Roche AG/Genentech, Inc; Gilead Sciences, Inc; Lilly; Merck & Co., Inc; Novartis Pharmaceuticals Corporation; OBI Pharma; Pfizer; Stemline Therapeutics. Consultant: Napo Therapeutics; Puma Biotechnology; Sanofi. Honoraria: Chugai; Mylan/Viatris. Neil M. Iyengar, MD Associate Attending, Breast Medicine Service Program Lead, MSK Healthy Living Department of Medicine Memorial Sloan Kettering Cancer Center Associate Professor of Medicine Weill Cornell Medical College New York, NY Disclosures: Consultant/Adviser: Arvinas, AstraZeneca, BD Life Sciences, Daiichi Sankyo, Genentech/Roche, Gilead, Menarini-Stemline, Novartis, Pfizer, Puma, Seagen, TerSera Therapeutics. Speaker: Cardinal Health, Curio Sciences, DAVA Oncology, IntrinsiQ Health. Editorial Position: npj Breast Cancer, Oncology®. Equity/Ownership: Complement Theory, Bettering Company. Research Support (to institution): American Cancer Society, Breast Cancer Research Foundation, Conquer Cancer Foundation, Kat's Ribbon of Hope, National Cancer Institute/National Institutes of Health. Contracted Research: Novartis, SynDevRx. Komal Jhaveri, MD, FACP Patricia and James Cayne Chair for Junior Faculty Associate Attending Physician, Breast Medicine Service and Early Drug Development Service Section Head, Endocrine Therapy Research Program Clinical Director, Early Drug Development Service Memorial Sloan Kettering Cancer Center Associate Professor of Clinical Medicine Weill Cornell Medical College New York, NY Disclosures: Consultant/Advisory Board: AbbVie Inc, AstraZeneca Pharmaceuticals LP, Blueprint Medicines, Bristol Myers Squibb, Daiichi Sankyo Inc, Eisai Inc, Genentech, a member of the Roche Group, Gilead Sciences Inc, Jounce Therapeutics, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, Menarini Group, Novartis, Olema Oncology, Pfizer Inc, Scorpion Therapeutics, Seagen Inc, Stemline Therapeutics Inc, Sun Pharma Advanced Research Company Ltd, Taiho Oncology Inc. Research Funding: AstraZeneca Pharmaceuticals LP, Debiopharm, Genentech, a member of the Roche Group, Gilead Sciences Inc, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, Merck, Novartis, Pfizer Inc, Puma Biotechnology Inc, Scorpion Therapeutics, Zymeworks Inc. The staff of Physicians' Education Resource®, LLC, have no relevant financial relationships with ineligible companies. PER® mitigated all COI for faculty, staff, and planners prior to the start of this activity by using a multistep process. Off-Label Disclosure and Disclaimer This activity may or may not discuss investigational, unapproved, or off-label use of drugs. Learners are advised to consult prescribing information for any products discussed. The information provided in this accredited activity is for continuing education purposes only and is not meant to substitute for the independent clinical judgment of a health care professional relative to diagnostic, treatment, or management options for a specific patient's medical condition. The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of PER® or any company that provided commercial support for this activity.

Welcome to the Oncology Brothers podcast! In this episode, Drs. Rahul and Rohit Gosain are joined by Dr. Mark Awad, a world-renowned thoracic medical oncologist from Memorial Sloan Kettering. Together, they dived deep into the treatment landscape for metastatic non-small cell lung cancer (NSCLC) without actionable mutations in frontline settings. Episode Highlights: •⁠  ⁠The importance of next-generation sequencing (NGS) and PD-L1 levels in treatment decision-making. •⁠  ⁠Current treatment options for patients with high PD-L1 scores, including single-agent immunotherapy. •⁠  ⁠Strategies for patients with low or intermediate PD-L1 scores, including chemotherapy combined with immunotherapy. •⁠  ⁠Discussed KRAS G12C and HER2 positive disease in second-line settings, including the latest approved therapies. •⁠  ⁠Insights into the potential side effects and considerations when transitioning from immunotherapy to targeted therapies. Join us as we explored the complexities of treating metastatic NSCLC and the ongoing need for clinical trials and biomarker discovery. Don't forget to check out our other episodes for more insights on treatment algorithms and recent FDA approvals! Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Don't forget to like, subscribe, and hit the notification bell for more updates from the Oncology Brothers!

This featured podcast includes a data review and candid conversation with 4 experts on challenges in the current treatment paradigm for hormone receptor–positive/HER2-negative (HR+/HER2–) metastatic breast cancer (mBC) due to endocrine resistance. This session occurred during a satellite symposium held in conjunction with the 42nd Annual Miami Breast Cancer Conference® in March 2025.  ESR1 mutations are a critical mechanism of resistance, spurring the development of next-generation endocrine agents targeting these mutations. These agents including oral selective estrogen receptor degraders (SERDs) and agents with novel mechanisms, including proteolysis-targeting chimeras (PROTACs), which may offer potential improvements over current treatments. This program will review mechanisms of resistance to current endocrine regimens, strategies to overcome this resistance including comparative mechanisms of novel endocrine agents, emerging data from ongoing clinical trials, and expert perspectives on where these new agents may fit into current algorithms.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/EBAC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/VPA865. CME/EBAC/NCPD/AAPA/IPCE credit will be available until April 26, 2026.Illuminating a Better Path Forward for HR+, HER2- MBC: Bridging the Science and Art of Medicine in Clinical Decision-Making In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and Breastcancer.org. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/EBAC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/VPA865. CME/EBAC/NCPD/AAPA/IPCE credit will be available until April 26, 2026.Illuminating a Better Path Forward for HR+, HER2- MBC: Bridging the Science and Art of Medicine in Clinical Decision-Making In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and Breastcancer.org. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/EBAC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/VPA865. CME/EBAC/NCPD/AAPA/IPCE credit will be available until April 26, 2026.Illuminating a Better Path Forward for HR+, HER2- MBC: Bridging the Science and Art of Medicine in Clinical Decision-Making In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and Breastcancer.org. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/EBAC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/VPA865. CME/EBAC/NCPD/AAPA/IPCE credit will be available until April 26, 2026.Illuminating a Better Path Forward for HR+, HER2- MBC: Bridging the Science and Art of Medicine in Clinical Decision-Making In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and Breastcancer.org. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.

In this episode of the Oncology Brothers podcast, Drs. Rahul & Rohit Gosain wrap up their three-part CME series on HER2-positive biliary tract cancer. Joined by Dr. Rachna Shroff, they delved into the critical topic of managing adverse events associated with treatments like TDXD and Zanidatamab. The discussion covered: •⁠  ⁠Overview of the treatment landscape for biliary tract cancer •⁠  ⁠Common side effects of TDXD, including interstitial lung disease, nausea, and fatigue •⁠  ⁠Management strategies for adverse events, including dose reductions and supportive care •⁠  ⁠Insights on Zanidatamab, its side effects, and infusion-related reactions •⁠  ⁠The importance of biomarker testing and patient-centered care in treatment decisions Tune in to gain valuable insights on how to improve patient quality of life while navigating the complexities of HER2-positive biliary tract cancer treatments. Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Don't forget to like, subscribe, and hit the notification bell for more updates from the Oncology Brothers!

This episode features the Beamion LUNG-1 trial, where zongertinib showed a 71% response rate in previously treated HER2-mutant NSCLC patients. The EAGLE-1 trial found gepotidacin non-inferior to standard treatment for urogenital gonorrhoea, with a 92.6% success rate. The U.S. Department of Health and Human Services and NIH launched the Generation Gold Standard initiative, a universal vaccine platform targeting pandemic-prone viruses, with trials ongoing for H5N1 avian influenza and coronaviruses.

In this episode, Catherine Fahey, MD, PhD; Alexandra Leary, MD, PhD; Funda Meric-Bernstam, MD; and Zev A. Wainberg, MD, explore the mechanisms of HER2-targeted antibody–drug conjugates (ADCs) and emerging clinical data with these agents across genitourinary, gastrointestinal, and gynecologic cancers.Mechanisms of action of ADCs: how ADCs selectively deliver potent chemotherapy to tumor cellsClinical data across tumor types: highlights from recent trials with trastuzumab deruxtecan and exploration of emerging data on agents such as disitamab vedotinChallenges and future directions:key considerations for combining HER2-targeted ADCs with immunotherapy or chemotherapy, and sequencing ADC therapiesPresenters:Catherine Fahey, MD, PhDAssistant ProfessorDivision of OncologyUniversity of North Carolina at Chapel HillChapel Hill, North CarolinaAlexandra Leary, MD, PhDPresident, GINECO GroupCo-Director, Department of Medical OncologyMedical Oncologist GynecologyTeam Leader, Gynecologic Translational Research Lab, INSERM u981Institut Gustave RoussyVillejuif, FranceFunda Meric-Bernstam, MDChair, Department of Investigational Cancer TherapeuticsMedical Director, Institute for Personalized Cancer TherapyNellie B. Connally Chair in Breast CancerThe University of Texas MD Anderson Cancer CenterHouston, TexasZev A. Wainberg, MDProfessor of Medicine and SurgeryCo-Director of GI OncologyDirector, Early Phase Clinical Research ProgramJonsson Comprehensive Cancer CenterUCLA School of MedicineLos Angeles, CaliforniaLink to full program:https://bit.ly/42iEDjVTo claim credit for listening to this episode, please visit the podcast online at the link above. 

Welcome to another episode of the Oncology Brothers podcast! In this episode, Drs. Rohit and Rahul Gosain, both practicing community medical oncologists, continue their discussion on HER2-positive biliary tract cancer. They are joined by Dr. Shubham Pant from MD Anderson, who shares his expertise on this rapidly evolving field. In this episode, we cover: •⁠  ⁠The importance of HER2 testing in biliary tract cancers, including intrahepatic and extrahepatic cholangiocarcinomas and gallbladder cancers. •⁠  ⁠Who should be tested for HER2 positivity and how to classify HER2-positive disease. •⁠  ⁠The role of next-generation sequencing (NGS) and immunohistochemistry (IHC) in determining HER2 status. •⁠  ⁠Current treatment options for HER2-positive biliary tract cancer, including the latest clinical trials and approved therapies like trastuzumab deruxtecan and zanidatamab. •⁠  ⁠The significance of patient-centered decision-making and managing side effects associated with these treatments. •⁠  ⁠Insights into the potential for brain metastases in biliary tract cancer and the importance of ongoing surveillance. Join us as we delve into the latest data and strategies for managing HER2-positive biliary tract cancer, and stay tuned for our next episode where we will discuss side effects and management of these therapies. Accreditation/Credit Designation Physicians' Education Resource®, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Physicians' Education Resource®, LLC designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Acknowledgment of Commercial Support This activity is supported by an educational grant from Jazz Pharmaceuticals, Inc. Link to gain CME credits from this activity: https://www.gotoper.com/courses/from-bench-to-bedside-paradigm-shifts-in-her2-metastatic-btc-treatment Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Don't forget to like, subscribe, and hit the notification bell for more updates from the Oncology Brothers!

Are you using the best approach for patients with HER2-positive biliary tract cancer (BTC)?   Credit available for this activity expires: 4/30/2026 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/1002492?ecd=bdc_podcast_libsyn_mscpedu

In this episode of the Onc Now Podcast, host Jonathan Sackier is joined by Janice Walshe, Consultant Medical Oncologist at St Vincent's University Hospital, Dublin, Ireland. They explore the economic realities of cancer diagnostics, fertility preservation in patients with breast cancer, and the impact of international collaboration on the future of clinical trials.  Timestamps:    00:00 – Introduction  03:25 – Economic disparities and oncology care in Ireland  07:20 – Neoadjuvant therapy for HER2-positive breast cancer  10:13 – Spotlight on invasive lobular carcinoma  12:36 – Fertility preservation in breast cancer  15:20 – Menopause after cancer  19:09 – The latest clinical trials in Ireland  21:50 – International trials and research projects  23:50 – Walshe's three wishes for healthcare 

Do you know the latest strategies to optimize care for HER2-positive gastric and gastroesophageal junction (GEJ) cancers?   Credit available for this activity expires: 4/30/2026 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/1002494?ecd=bdc_podcast_libsyn_mscpedu

This is the second episode of a two-part series on the HER2 diagnostic and treatment landscape in non-small cell lung cancer (NSCLC), hosted by the Oncology Brothers, Drs Rohit and Rahul Gosain.      In this episode, Dr Isabel Preeshagul and Dr Eric Singhi provide the benefit of their experience when discussing how to approach different treatment scenarios in HER2-mutant NSCLC.   The conversation unfolds to cover: • Ways to distinguish HER2 alterations from other alterations on biomarker reports  • The latest efficacy and safety data of currently approved and emerging treatments for HER2-altered NSCLC   • The potential CNS activity of these treatments in patients with HER2-mutated NSCLC  • How the treatment pathway may look in the near future      Clinical takeaways • In NSCLC, HER2-positivity includes mutations, amplifications and overexpression. It's important to distinguish HER2 alterations from EGFR mutations, particularly exon 20 insertions, when interpreting next-generation sequencing (NGS) results  • Trastuzumab Deruxtecan (T-DXd) is currently the only approved targeted agent for HER2-altered NSCLC in the 2nd-line setting. It shows promising efficacy, especially in HER2-mutant cases, but has limited brain penetration and is associated with notable side effects, including pneumonitis, which requires close monitoring  • Emerging TKIs, such as zongertinib, BAY 2927088 (sevabertinib), and NVL-330, target HER2-mutations and have shown high response rates and CNS activity in early studies, without ILD/pneumonitis. These treatments come with unique side effects like diarrhoea and rash, which can be managed with supportive care  • CNS metastases are common, with up to 30% of HER2-altered NSCLC patients presenting with or quickly developing CNS metastases. Current large molecule therapies (like T-DXd) have limited brain penetration, making small-molecule TKIs, like zongertinib, BAY 2927088 (sevabertinib), and NVL-330, promising for their potential CNS activity • Current standard 1st-line care for HER2-mutant NSCLC remains platinum-based chemotherapy ± immunotherapy. Targeted agents (like T-DXd) are generally reserved for 2nd-line use, but ongoing trials are evaluating the move toward frontline therapy Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Don't forget to subscribe for the next episode

- Overview of HER2 Low Breast Cancer - What is the HER2 Status of My Cancer? What does this Mean? - Diagnostic Testing: What is an Immunohistochemistry (IHC) Test or Fluorescence In Situ Hybridization (FISH) Test - The Role of the Pathologist - The Role of the Genetic Counselor - Standard Treatment Options, Including Targeted Therapy - How Biomarker Testing Informs Treatment Decisions - New Targeted Treatments - Updates on Investigational New Drugs in Clinical Trials - How Research Contributes to Treatment Options - What's New in the Prevention & Management of Treatment Side Effects, Symptoms, Discomfort & Pain - The Role of the Dietitian - Guidelines to Prepare for Telemedicine/Telehealth Appointments, Including Technology, Prepared List of Questions & Discussion of OpenNotes - Key Questions to Ask Your Health Care Team About Quality-of-Life Concerns for HER2 Low Breast Cancer - Questions for Our Panel of Experts

In this podcast episode, Allison Butts, PharmD, BCOP, reviews how pharmacists can help in providing comprehensive patient-centric care for patients with HR+/HER2- MBC and preexisting comorbid conditions, including:Common comorbidities and complexities in managing patients with HR+/HER2- MBCTreatment landscape for patients with HR+/HER2- MBCReal-world studies in women with HR+/HER2- MBCMitigation and management of drug interactions and multidisciplinary team coordination treatment selectionPatient goals and coordinating with multidisciplinary team to maximize quality of lifeLink to full program:https://bit.ly/4jCQe38

- Overview of HER2 Low Breast Cancer - What is the HER2 Status of My Cancer? What does this Mean? - Diagnostic Testing: What is an Immunohistochemistry (IHC) Test or Fluorescence In Situ Hybridization (FISH) Test - The Role of the Pathologist - The Role of the Genetic Counselor - Standard Treatment Options, Including Targeted Therapy - How Biomarker Testing Informs Treatment Decisions - New Targeted Treatments - Updates on Investigational New Drugs in Clinical Trials - How Research Contributes to Treatment Options - What's New in the Prevention & Management of Treatment Side Effects, Symptoms, Discomfort & Pain - The Role of the Dietitian - Guidelines to Prepare for Telemedicine/Telehealth Appointments, Including Technology, Prepared List of Questions & Discussion of OpenNotes - Key Questions to Ask Your Health Care Team About Quality-of-Life Concerns for HER2 Low Breast Cancer - Questions for Our Panel of Experts

Featuring an interview with Dr Adam M Brufsky, including the following topics: Case: A woman in her early 50s with ER-positive, HER2-low de novo metastatic breast cancer (0:00) Case: A woman in her late 70s with ER-positive, HER2-low metastatic breast cancer after 5 years of an adjuvant aromatase inhibitor (6:52) Clinical Investigator Survey Results (10:05) CME information and select publications

In this podcast episode, Allison Butts, PharmD, BCOP, reviews how pharmacists can help in providing comprehensive patient-centric care for patients with HR+/HER2- MBC and preexisting comorbid conditions, including:Common comorbidities and complexities in managing patients with HR+/HER2- MBCTreatment landscape for patients with HR+/HER2- MBCReal-world studies in women with HR+/HER2- MBCMitigation and management of drug interactions and multidisciplinary team coordination treatment selectionPatient goals and coordinating with multidisciplinary team to maximize quality of lifeLink to full program:https://bit.ly/4jCQe38

Welcome to the Oncology Brothers podcast! In this episode, Drs. Rohit and Rahul Gosain are joined by Dr. Ghassan Abou-Alfa, a medical oncologist specializing in the hepatobiliary space at Memorial Sloan Kettering. Together, they explored the current treatment landscape of biliary tract cancer, focusing on the advancements in HER2-driven therapies.   Key topics discussed included: • The evolution of treatment options for biliary tract cancer, including chemotherapy and immunotherapy. • The significance of genetic testing, including IDH1 mutations, FGFR alterations, and HER2 status. • The role of multidisciplinary collaboration in managing hepatobiliary cancers. • Insights into the latest clinical trials and emerging therapies for HER2-positive biliary tract cancer.   Join us as we delve into the complexities of biliary tract cancer and the promising developments in HER2-targeted treatments. Don't forget to check out our next episode, where we will take a deeper dive into the data surrounding HER2 therapies and discuss management strategies for common side effects.   YouTube: https://youtu.be/pGiU7JJGNOc   Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/   Subscribe to stay updated on the latest in oncology! #OncologyBrothers #BiliaryTractCancer #HER2 #CancerTreatment #MedicalOncology #CME #Podcast

Join us for an insightful episode of the Oncology Brothers podcast as we dive into the fast-evolving landscape of HER2-positive non-small cell lung cancer (NSCLC). In this first part of the two-part series, Drs. Rahul and Rohit Gosain were joined by Dr. Devika Das, a thoracic medical oncologist, and Dr. Fernando Lopez-Rios, a pathologist, to discuss the critical importance of testing and identifying HER2 alterations in lung cancer patients. In this episode, we covered: •⁠  ⁠The significance of HER2 alterations in NSCLC and how they differ from breast and gastric cancers. •⁠  ⁠The complexities of biomarker testing, including NGS, IHC, and FISH amplification. •⁠  ⁠Patient characteristics and phenotypes associated with HER2-positive disease. •⁠  ⁠The current testing workflows in clinical practice and the role of liquid biopsies. •⁠  ⁠Insights into the treatment landscape for HER2-positive NSCLC, including recent FDA approvals and ongoing clinical trials. Whether you're a healthcare professional or simply interested in the latest advancements in oncology, this episode provides valuable information on the integration of precision medicine in lung cancer treatment. YouTube: https://youtu.be/gMi-sflQyQo Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Don't forget to subscribe for the next episode, where we will explore treatment options for HER2-positive non-small cell lung cancer in greater detail!

Clinical investigators discuss available data guiding the management of HER2-positive, triple-negative and localized breast cancer.  CME information and select publications here.

In this episode, Zev A. Wainberg, MD; Funda Meric-Bernstam, MD; Alexandra Leary, MD, PhD; and Catherine Fahey, MD, PhD, explore testing for HER2 alterations and the incidence of HER2-positive disease in the treatment of genitourinary, gastrointestinal, and gynecologic malignancies. HER2 Testing in Advanced Cancers: Recommendations for when and how to test for HER2 in advanced cancers and how these tests guide therapy selectionVariability in HER2 Expression Across Tumor Types: Insights into the heterogeneity of HER2 expression and amplification in different cancersChallenges in Standardizing HER2 Testing: The complexities of scoring and testing HER2 in different cancers and institutions, and the need for better harmonization of guidelines and approachesPresenters:Zev A. Wainberg, MDProfessor of Medicine and SurgeryCo-Director of GI OncologyDirector, Early Phase Clinical Research ProgramJonsson Comprehensive Cancer CenterUCLA School of MedicineLos Angeles, CaliforniaFunda Meric-Bernstam, MDChair, Department of Investigational Cancer TherapeuticsMedical Director, Institute for Personalized Cancer TherapyNellie B. Connally Chair in Breast CancerThe University of Texas MD Anderson Cancer CenterHouston, TexasAlexandra Leary, MD, PhDPresident, GINECO GroupCo-Director, Department of Medical OncologyMedical Oncologist GynecologyTeam Leader, Gynecologic Translational Research Lab, INSERM u981Institut Gustave RoussyVillejuif, FranceCatherine Fahey, MD, PhDAssistant ProfessorDivision of OncologyUniversity of North Carolina at Chapel HillChapel Hill, North CarolinaLink to full program:https://bit.ly/42iEDjVTo claim credit for listening to this episode, please visit the podcast online at the link above. 

Featuring perspectives from Dr Aditya Bardia, Dr Virginia F Borges, Dr Harold J Burstein and Dr Joyce O'Shaughnessy, including the following topics: Introduction (0:00) HER2-Positive Breast Cancer — Dr O'Shaughnessy (3:13) Triple-Negative Breast Cancer — Dr Bardia (32:56) Personalizing Adjuvant Therapy for Patients with HR-Positive Breast Cancer — Dr Borges (57:35) Current Role of CDK4/6 Inhibitors in the Localized Setting — Dr Burstein (1:25:15) CME information and select publications

Can people diagnosed with metastatic hormone receptor-positive breast cancer avoid chemotherapy and take a CDK4/6 inhibitor instead? Do people diagnosed with DCIS need to have surgery? Will there soon be another oral selective estrogen degrader available? Breastcancer.org medical advisor Dr. Kevin Fox explains the details of the studies and what they mean for you. Listen to the episode to hear Dr. Fox discuss these studies: Young-PEARL: Ibrance plus Aromasin, along with ovarian suppression, offers better progression-free survival than Xeloda for pre-menopausal women with metastatic hormone receptor-positive, HER2-negative breast cancer who had previously received tamoxifen. PATINA: Adding Ibrance to standard-of-care first treatments for metastatic hormone receptor-positive, HER2-positive breast cancer increased progression-free survival by more than a year. EMBER-3:Imlunestrant led to longer progression-free survival than standard therapy if the cancer had an ESR1 mutation among people with estrogen receptor-positive, HER2-negative advanced-stage breast cancer. Adding Verzenio to imlunestrant improved progression-free survival compared to imlunestrant alone, whether the cancer had an ESR1-mutation or not. COMET: Can people with low-risk DCIS just be monitored instead of having surgery with or without radiation? 

Please visit answersincme.com/860/95483855-replay3 to participate, download slides and supporting materials, complete the post test, and obtain credit. In this activity, experts in oncology discuss practical strategies for integrating antibody-drug conjugates in special populations with HER2-low advanced breast cancer and essential adverse event management approaches. Upon completion of this activity, participants should be better able to: Review guideline-concordant approaches to individualize treatment selection for patients with HER2-low and -ultralow advanced breast cancer; and Outline evidence-based strategies to enhance the management of patients with HER2-low and -ultralow advanced breast cancer.

Study compared the prognostic impact of differing high-risk inclusion criteria used in the monarchE and NATALEE trials among patients with hormone receptor-positive/HER2-negative early #BreastCancer , using data from the MIG1, GIM2, and GIM3 trials. Patients were stratified into high- and low-risk cohorts per each trial's criteria, and further grouped into concordant low-risk, discordant risk, and concordant high-risk categories.Link to Articlehttps://academic.oup.com/jnci/advance-article/doi/10.1093/jnci/djaf031/8002826?login=false#google_vignette

Dr. Ko Un “Clara” Park and Dr. Mylin Torres present the latest evidence-based changes to the SLNB in early-stage breast cancer guideline. They discuss the practice-changing trials that led to the updated recommendations and topics such as when SLNB can be omitted, when ALND is indicated, radiation and systemic treatment decisions after SLNB omission, and the role of SLNB in special circumstances. We discuss the importance of shared decision-making and other ongoing and future de-escalation trials that will expand knowledge in this space. Read the full guideline update, “Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer: ASCO Guideline Update” at www.asco.org/breast-cancer-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/breast-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO-25-00099       Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges and advances in oncology. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey and today I'm interviewing Dr. Ko Un "Clara" Park from Brigham and Women's Hospital, Dana-Farber Cancer Institute, and Dr. Mylin Torres from Glenn Family Breast Center at Winship Cancer Institute of Emory University, co-chairs on “Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer: ASCO Guideline Update.” Thank you for being here today, Dr. Park and Dr. Torres. Dr. Mylin Torres: Thank you, it's a pleasure to be here. Brittany Harvey: And before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Torres and Dr. Park, who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. To start us off, Dr. Torres, what is the scope and purpose of this guideline update on the use of sentinel lymph node biopsy in early-stage breast cancer? Dr. Mylin Torres: The update includes recommendations incorporating findings from trials released since our last published guideline in 2017. It includes data from nine randomized trials comparing sentinel lymph node biopsy alone versus sentinel lymph node biopsy with a completion axillary lymph node dissection. And notably, and probably the primary reason for motivating this update, are two trials comparing sentinel lymph node biopsy with no axillary surgery, all of which were published from 2016 to 2024. We believe these latter two trials are practice changing and are important for our community to know about so that it can be implemented and essentially represent a change in treatment paradigms. Brittany Harvey: It's great to hear about these practice changing trials and how that will impact these recommendation updates. So Dr. Park, I'd like to start by reviewing the key recommendations across all of these six overarching clinical questions that the guideline addressed. So first, are there patients where sentinel lymph node biopsy can be omitted? Dr. Ko Un "Clara" Park: Yes. The key change in the current management of early-stage breast cancer is the inclusion of omission of sentinel lymph node biopsy in patients with small, less than 2 cm breast cancer and a negative finding on preoperative axillary ultrasound. The patients who are eligible for omission of sentinel lymph node biopsy according to the SOUND and INSEMA trial are patients with invasive ductal carcinoma that is size smaller than 2 cm, Nottingham grades 1 and 2, hormone receptor-positive, HER2-negative in patients intending to receive adjuvant endocrine therapy, and no suspicious lymph nodes on axillary ultrasound or if they have only one suspicious lymph node, then the biopsy of that lymph node is benign and concordant according to the axillary ultrasound findings. The patients who are eligible for sentinel lymph node biopsy omission according to the SOUND and INSEMA trials were patients who are undergoing lumpectomy followed by whole breast radiation, especially in patients who are younger than 65 years of age. For patients who are 65 years or older, they also qualify for omission of sentinel lymph node biopsy in addition to consideration for radiation therapy omission according to the PRIME II and CALGB 9343 clinical trials. And so in those patients, a more shared decision-making approach with the radiation oncologist is encouraged. Brittany Harvey: Understood. I appreciate you outlining that criteria for when sentinel lymph node biopsy can be omitted and when shared decision making is appropriate as well. So then, Dr. Torres, in those patients where sentinel lymph node biopsy is omitted, how are radiation and systemic treatment decisions impacted? Dr. Mylin Torres: Thank you for that question. I think there will be a lot of consternation brought up as far as sentinel lymph node biopsy and the value it could provide in terms of knowing whether that lymph node is involved or not. But as stated, sentinel lymph node biopsy actually can be safely omitted in patients with low risk disease and therefore the reason we state this is that in both SOUND and INSEMA trial, 85% of patients who had a preoperative axillary ultrasound that did not show any signs of a suspicious lymph node also had no lymph nodes involved at the time of sentinel node biopsy. So 85% of the time the preoperative ultrasound is correct. So given the number of patients where preoperative ultrasound predicts for no sentinel node involvement, we have stated within the guideline that radiation and systemic treatment decisions should not be altered in the select patients with low risk disease where sentinel lymph node biopsy can be omitted. Those are the patients who are postmenopausal and age 50 or older who have negative findings on preoperative ultrasound with grade 1 or 2 disease, small tumors less than or equal to 2 cm, hormone receptor-positive, HER2-negative breast cancer who undergo breast conserving therapy. Now, it's important to note in both the INSEMA and SOUND trials, the vast majority of patients received whole breast radiation. In fact, within the INSEMA trial, partial breast irradiation was not allowed. The SOUND trial did allow partial breast irradiation, but in that study, 80% of patients still received whole breast treatment. Therefore, the preponderance of data does support whole breast irradiation when you go strictly by the way the SOUND and INSEMA trials were conducted. Notably, however, most of the patients in these studies had node-negative disease and had low risk features to their primary tumors and would have been eligible for partial breast irradiation by the ASTRO Guidelines for partial breast treatment. So, given the fact that 85% of patients will have node-negative disease after a preoperative ultrasound, essentially what we're saying is that partial breast irradiation may be offered in these patients where omission of sentinel node biopsy is felt to be safe, which is in these low risk patients. Additionally, regional nodal irradiation is something that is not indicated in the vast majority of patients where omission of sentinel lymph node biopsy is prescribed and recommended, and that is because very few of these patients will actually end up having pathologic N2 disease, which is four or more positive lymph nodes. If you look at the numbers from both the INSEMA and the SOUND trial, the number of patients with pathologic N2 disease who did have their axilla surgically staged, it was less than 1% in both trials. So, in these patients, regional nodal irradiation, there would be no clear indication for that more aggressive and more extensive radiation treatment. The same principles apply to systemic therapy. As the vast majority of these patients are going to have node-negative disease with a low risk primary tumor, we know that postmenopausal women, even if they're found to have one to three positive lymph nodes, a lot of the systemic cytotoxic chemotherapy decisions are driven by genomic assay score which is taken from the primary tumor. And therefore nodal information in patients who have N1 disease may not be gained in patients where omission of sentinel lymph node biopsy is indicated in these low risk patients. 14% of patients have 1 to 3 positive lymph nodes in the SOUND trial and that number is about 15% in the INSEMA trial. Really only the clinically actionable information to be gained is if a patient has four or more lymph nodes or N2 disease in this low risk patient population. So, essentially when that occurs it's less than 1% of the time in these patients with very favorable primary tumors. And therefore we thought it was acceptable to stand by a recommendation of not altering systemic therapy or radiation recommendations based on omission of sentinel nodes because the likelihood of having four more lymph nodes is so low. Dr. Ko Un "Clara" Park: I think one thing to add is the use of CDK4/6 inhibitors to that and when we look at the NATALEE criteria for ribociclib in particular, where node-negative patients were included, the bulk majority of the patients who were actually represented in the NATALEE study were stage III disease. And for stage I disease to upstage into anatomic stage III, that patient would need to have pathologic N2 disease. And as Dr. Torres stated, the rate of having pathologic N2 disease in both SOUND and INSEMA studies were less than 1%. And therefore it would be highly unlikely that these patients would be eligible just based on tumor size and characteristics for ribociclib. So we think that it is still safe to omit sentinel lymph node biopsy and they would not miss out, if you will, on the opportunity for CDK4/6 inhibitors. Brittany Harvey: Absolutely. I appreciate you describing those recommendations and then also the nuances of the evidence that's underpinning those recommendations, I think that's important for listeners. So Dr. Park, the next clinical question addresses patients with clinically node negative early stage breast cancer who have 1 or 2 sentinel lymph node metastases and who will receive breast conserving surgery with whole breast radiation therapy. For these patients, is axillary lymph node dissection needed? Dr. Ko Un "Clara" Park: No. And this is confirmed based on the ACOSOG Z0011 study that demonstrated in patients with 1 to 3 positive sentinel lymph node biopsy when the study compared completion axillary lymph node dissection to no completion axillary lymph node dissection, there was no difference. And actually, the 10-year overall survival as reported out in 2017 and at a median follow up of 9.3 years, the overall survival again for patients treated with sentinel lymph node biopsy alone versus those who were treated with axillary lymph node dissection was no different. It was 86.3% in sentinel lymph node biopsy versus 83.6% and the p-value was non-inferior at 0.02. And so we believe that it is safe for the select patients who are early stage with 1 to 2 positive lymph nodes on sentinel lymph node biopsy, undergoing whole breast radiation therapy to omit completion of axillary lymph node dissection. Brittany Harvey: Great, I appreciate you detailing what's recommended there as well. So then, to continue our discussion of axillary lymph node dissection, Dr. Torres, for patients with nodal metastases who will undergo mastectomy, is axillary lymph node dissection indicated? Dr. Mylin Torres: It's actually not and this is confirmed by two trials, the AMAROS study as well as the SENOMAC trial. And in both studies, they compared a full lymph node dissection versus sentinel lymph node biopsy alone in patients who are found to have 1 to 2 positive lymph nodes and confirmed that there was no difference in axillary recurrence rates, overall survival or disease-free survival. What was shown is that with more aggressive surgery completion axillary lymph node dissection, there were higher rates of morbidity including lymphedema, shoulder pain and paresthesias and arm numbness, decreased functioning of the arm and so there was only downside to doing a full lymph node dissection. Importantly, in both trials, if a full lymph node dissection was not done in the arm that where sentinel lymph node biopsy was done alone, all patients were prescribed post mastectomy radiation and regional nodal treatment and therefore both studies currently support the use of post mastectomy radiation and regional nodal treatment when a full lymph node dissection is not performed in these patients who are found to have N1 disease after a sentinel node biopsy. Brittany Harvey: Thank you. And then Dr. Park, for patients with early-stage breast cancer who do not have nodal metastases, can completion axillary lymph node dissection be omitted? Dr. Ko Un "Clara" Park: Yes, and this is an unchanged recommendation from the earlier ASCO Guidelines from 2017 as well as the 2021 joint guideline with Ontario Health, wherein patients with clinically node-negative early stage breast cancer, the staging of the axilla can be performed through sentinel lymph nodal biopsy and not completion axillary lymph node dissection. Brittany Harvey: Understood. So then, to wrap us up on the clinical questions here, Dr. Park, what is recommended regarding sentinel lymph node biopsy in special circumstances in populations? Dr. Ko Un "Clara" Park: One key highlight of the special populations is the use of sentinel lymph node biopsy for evaluation of the axilla in clinically node negative multicentric tumors. While there are no randomized clinical trials evaluating specifically the role of sentinel lymph nodal biopsy in multicentric tumors, in the guideline, we highlight this as one of the safe options for staging of the axilla and also for pregnant patients, these special circumstances, it is safe to perform sentinel lymph node biopsy in pregnant patients with the use of technetium - blue dye should be avoided in this population. In particular, I want to highlight where sentinel lymph node biopsy should not be used for staging of the axilla and that is in the population with inflammatory breast cancer. There are currently no studies demonstrating that sentinel lymph node biopsy is oncologically safe or accurate in patients with inflammatory breast cancer. And so, unfortunately, in this population, even after neoadjuvant systemic therapy, if they have a great response, the current guideline recommends mastectomy with axillary lymph node dissection. Brittany Harvey: Absolutely. I appreciate your viewing both where sentinel lymph node can be offered in these special circumstances in populations and where it really should not be used. So then, Dr. Torres, you talked at the beginning about how there's been these new practice changing trials that really impacted these recommendations. So in your view, what is the importance of this guideline update and how does it impact both clinicians and patients? Dr. Mylin Torres: Thank you for that question. This update and these trials that inform the update represent a significant shift in the treatment paradigm and standard of care for breast cancer patients with early-stage breast cancer. When you think about it, it seems almost counterintuitive that physicians and patients would not want to know if a lymph node is involved with cancer or not through sentinel lymph node biopsy procedure. But what these studies show is that preoperative axillary ultrasound, 85% of the time when it's negative, will correctly predict whether a sentinel lymph node is involved with cancer or not and will also be negative. So if you have imaging that's negative, your surgery is likely going to be negative. Some people might ask, what's the harm in doing a sentinel lymph node biopsy? It's important to recognize that upwards of 10% of patients, even after sentinel lymph node biopsy will develop lymphedema, chronic arm pain, shoulder immobility and arm immobility. And these can have a profound impact on quality of life. And if there is not a significant benefit to assessing lymph nodes, particularly in someone who has a preoperative axillary ultrasound that's negative, then why put a patient at risk for these morbidities that can impact them lifelong? Ideally, the adoption of omission of sentinel lymph node biopsy will lead to more multidisciplinary discussion and collaboration in the preoperative setting especially with our diagnostic physicians, radiology to assure that these patients are getting an axillary ultrasound and determine how omission of sentinel lymph node biopsy may impact the downstream treatments after surgery, particularly radiation and systemic therapy decisions, and will be adopted in real world patients, and how clinically we can develop a workflow where together we can make the best decisions for our patients in collaboration with them through shared decision making. Brittany Harvey: Absolutely. It's great to have these evidence-based updates for clinicians and patients to review and refer back to. So then finally, Dr. Park, looking to the future, what are the outstanding questions and ongoing trials regarding sentinel lymph node biopsy in early-stage breast cancer? Dr. Ko Un "Clara" Park: I think to toggle on Dr. Torres's comment about shared decision making, the emphasis on that I think will become even more evident in the future as we incorporate different types of de-escalation clinical studies. In particular, because as you saw in the SOUND and INSEMA studies, when we de-escalate one modality of the multimodality therapy, i.e., surgery, the other modalities such as radiation therapy and systemic therapy were “controlled” where we were not de-escalating multiple different modalities. However, as the audience may be familiar with, there are other types of de-escalation studies in particular radiation therapy, partial breast irradiation or omission of radiation therapy, and in those studies, the surgery is now controlled where oftentimes the patients are undergoing surgical axillary staging. And conversely when we're looking at endocrine therapy versus radiation therapy clinical trials, in those studies also the majority of the patients are undergoing surgical axillary staging. And so now as those studies demonstrate the oncologic safety of omission of a particular therapy, we will be in a position of more balancing of the data of trying to select which patients are the safe patients for omission of certain types of modality, and how do we balance whether it's surgery, radiation therapy, systemic therapy, endocrine therapy. And that's where as Dr. Torres stated, the shared decision making will become critically important. I'm a surgeon and so as a surgeon, I get to see the patients oftentimes first, especially when they have early-stage breast cancer. And so I could I guess be “selfish” and just do whatever I think is correct. But whatever the surgeon does, the decision does have consequences in the downstream decision making. And so the field really needs to, as Dr. Torres stated earlier, rethink the workflow of how early-stage breast cancer patients are brought forth and managed as a multidisciplinary team. I also think in future studies the expansion of the data to larger tumors, T3, in particular,reater than 5 cm and also how do we incorporate omission in that population will become more evident as we learn more about the oncologic safety of omitting sentinel lymph node biopsy. Dr. Mylin Torres: In addition, there are other outstanding ongoing clinical trials that are accruing patients right now. They include the BOOG 2013-08 study, SOAPET, NAUTILUS and the VENUS trials, all looking at patients with clinical T1, T2N0 disease and whether omission of sentinel lymph node biopsy is safe with various endpoints including regional recurrence, invasive disease-free survival and distant disease-free survival. I expect in addition to these studies there will be more studies ongoing even looking at the omission of sentinel lymph node biopsy in the post-neoadjuvant chemotherapy setting. And as our imaging improves in the future, there will be more studies improving other imaging modalities, probably in addition to axillary ultrasound in an attempt to accurately characterize whether lymph nodes within axilla contain cancer or not, and in that context whether omission of sentinel lymph node biopsy even in patients with larger tumors post-neoadjuvant chemotherapy may be done safely and could eventually become another shift in our treatment paradigm. Brittany Harvey: Yes. The shared decision making is key as we think about these updates to improve quality of life and we'll await data from these ongoing trials to inform future updates to this guideline. So I want to thank you both so much for your extensive work to update this guideline and thank you for your time today. Dr. Park and Dr. Torres. Dr. Mylin Torres: Thank you. Dr. Ko Un "Clara" Park: Thank you. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/breast-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

Please visit answersincme.com/BCQ860 to participate, download slides and supporting materials, complete the post test, and obtain credit. In this activity, an expert in breast cancer discusses use of TROP2-directed antibody-drug conjugates for the management of hormone receptor–positive, HER2-negative metastatic disease. Upon completion of this activity, participants should be better able to: Identify the available TROP2-directed ADCs for management of HR+, HER2- metastatic breast cancer (mBC); Outline the efficacy and safety of available and emerging TROP2-directed ADCs for HR+, HER2- mBC; and Apply personalization factors to help identify the optimal therapy for each individual patient with HR+, HER2- mBC.

Please visit answersincme.com/860/95483855-replay2 to participate, download slides and supporting materials, complete the post test, and obtain credit. In this activity, experts in oncology discuss antibody-drug conjugates in HER2-low advanced breast cancer, including current guideline recommendations and evolving treatment considerations to optimize individualized care. Upon completion of this activity, participants should be better able to: Review guideline-concordant approaches to individualize treatment selection for patients with HER2-low and -ultralow advanced breast cancer; and Outline evidence-based strategies to enhance the management of patients with HER2-low and -ultralow advanced breast cancer.

Featuring an interview with Dr Adrienne G Waks, including the following topics: The Phase III AFT-38 PATINA trial of palbociclib combined with anti-HER2 therapy for hormone receptor (HR)-positive/HER2-positive metastatic breast cancer (mBC) (0:00) Role of immunotherapy in the treatment of breast cancer (8:30) Defining ER-low breast cancer and identifying treatment approaches for this histologic subtype (15:55) Genomic testing approaches for patients with localized breast cancer and identification of candidates for treatment with adjuvant olaparib (19:37) Current role of anthracyclines in the treatment of localized breast cancer (31:17) Available and novel antibody-drug conjugates for the treatment of breast cancer (41:21) Palbociclib with endocrine therapy compared to chemotherapy induction followed by endocrine therapy maintenance for HR-positive, HER2-negative mBC (51:53) CME information and select publications

Featuring a slide presentation and related discussion from Dr Adrienne G Waks, including the following topics: Updated analyses from key studies of the 21-gene Recurrence Score® for localized ER-positive breast cancer (29:30) Four-year landmark analysis of the NATALEE trial of adjuvant ribociclib with nonsteroidal aromatase inhibitor for localized breast cancer (9:49) The PADMA trial of palbociclib with endocrine therapy compared to chemotherapy induction followed by endocrine therapy maintenance for hormone receptor (HR)-positive, HER2-negative metastatic breast cancer (mBC) (11:25) Imlunestrant with or without abemaciclib for metastatic ER-positive mBC (13:18) TROP2-directed antibody-drug conjugates (ADCs) datopotamab deruxtecan and sacituzumab tirumotecan for HR-positive/HER2-negative mBC (17:50) Recent analyses from the DESTINY-Breast06 trial of trastuzumab deruxtecan (T-DXd) after endocrine therapy for HR-positive, HER2-low or HER2-ultralow mBC (21:09) The ICARUS-BREAST01 Phase II trial of the HER3-targeted ADC patritumab deruxtecan for HR-positive/HER2-negative mBC (26:02) Updates from neoadjuvant/adjuvant trials of pembrolizumab (KEYNOTE-522) and atezolizumab (NSABP B-59/GBG 96-GeparDouze) for localized triple-negative breast cancer (TNBC) (27:36) Ten-year update of the OlympiA trial of adjuvant olaparib for patients with germline BRCA1/2-mutated HER2-negative localized breast cancer (31:23) Exploratory analysis of patients who did or did not receive prior PD-1/PD-L1 inhibition in the Phase III OptiTROP-Breast01 study of sacituzumab tirumotecan versus chemotherapy for previously treated advanced TNBC (32:56) CNS efficacy of T-DXd (DESTINY-Breast12 trial) and outcomes with palbociclib combined with anti-HER2 therapy (AFT-38 PATINA trial) for HER2-positive mBC (34:04) CME information and select publications

Please visit answersincme.com/860/95483855-replay1 to participate, download slides and supporting materials, complete the post test, and obtain credit. In this activity, experts in oncology and pathology discuss the evolving classification of HER2 status in advanced breast cancer, including HER2 low and HER2 ultralow, and its impact on treatment decisions. Upon completion of this activity, participants should be better able to: Identify strategies to enhance the identification of HER2-low and -ultralow status in patients with advanced breast cancer; and Review guideline-concordant approaches to individualize treatment selection for patients with HER2-low and -ultralow advanced breast cancer,

Featuring perspectives from Dr Kathleen N Moore, Dr David M O'Malley and Dr Alessandro D Santin, moderated by Dr O'Malley, including the following topics: Introduction (0:00) Strategies to Identify Patients with HER2-Positive Gynecologic Cancers — Dr Santin (2:17) Available Data with and Practical Application of HER2-Targeted Therapy for Advanced Gynecologic Cancers — Dr O'Malley (30:24) Identification and Management of Adverse Events with Trastuzumab Deruxtecan — Dr Moore (1:01:53) CME information and select publications

In this week's episode of MedNews Week's Oncology Unplugged, host Chandler Park, MD, a medical oncologist at Norton Cancer Institute in Louisville, Kentucky, sat down with Vadim Koshkin, MD, an associate professor of medicine in the Division of Hematology and Oncology in the Department of Medicine at the University of California, San Francisco (UCSF) School of Medicine, as well as a genitourinary medical oncologist at the UCSF Helen Diller Comprehensive Cancer Center. Drs Park and Koshkin discussed recent developments in bladder cancer management, including the significant benefits of enfortumab vedotin-ejfv (Padcev) plus pembrolizumab (Keytruda) compared with platinum-based chemotherapy in the metastatic setting, key outcomes from the phase 3 NIAGARA trial (NCT03732677) of perioperative durvalumab (Imfinzi) plus chemotherapy in muscle-invasive bladder cancer, the potential for disitamab vedotin (RC48-ADC) to join the advanced urothelial cancer treatment paradigm, and what the future may look like for HER2-targeted therapies in this disease.

Drs. Yu and Sabari trace the evolution of HER2-mutant lung cancer treatment from chemotherapy to targeted therapies, highlighting key advancements, challenges, and patient responses. They also explore emerging treatment strategies, resistance mechanisms, and the future of personalized therapy based on biomarkers and co-mutations.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/CC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/DEJ865. CME/MOC/CC/NCPD/CPE/AAPA/IPCE credit will be available until March 26, 2026.Intelligently Achieving the Potential of Adjuvant CDK4/6 Inhibition in Reducing Risk of Recurrence While Maintaining QOL in HR+, HER2- EBC: An AI-Driven Educational Resource for Improving MDT Collaboration and Patient-Clinician Communication In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.

Drs. Sabari and Yu discuss the molecular landscape of HER2-mutant lung cancer, including its genomic characteristics, common co-mutations, and differences between HER2 mutations and HER2 amplification. This discussion also explores the prevalence and clinical patterns of HER2 mutations, their oncogenic mechanisms, their impact on tumor behavior and metastases, and potential environmental or genetic contributors to their development.

Welcome to another episode of the Oncology Brothers! In this episode, Drs. Rahul and Rohit Gosain are joined by their brother, Dr. Timothy Brown from UT Southwestern, to discuss the latest treatment paradigms for upper gastrointestinal (GI) malignancies, specifically focusing on esophageal and gastroesophageal junction adenocarcinoma, as well as gastric cancer. Episode Highlights: •⁠  ⁠Early Disease Management: perioperative FLOT versus concurrent chemoradiation. •⁠  ⁠Adjuvant Nivolumab: Insights from the Checkmate 577 trial and its implications for patients with residual disease post-chemoradiation. •⁠  ⁠Biomarker Testing: The importance of testing for MSI, HER2, Claudin 18.2, and PD-L1 to guide treatment decisions in metastatic settings. •⁠  ⁠Patient-Centered Care: Emphasizing the significance of shared decision-making and multidisciplinary approaches in managing complex cases. Join us as we unpack the nuances of upper GI malignancies and share key takeaways from recent studies and clinical practices.  YouTube: https://youtu.be/UNyi71u2wIw Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Don't forget to like, subscribe, and hit the notification bell for more updates on treatment algorithms and oncology insights!  

How do the eligibility criteria for the monarchE and NATALEE clinical trials compare? Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/1002403?ecd=bdc_podcast_libsyn_mscpedu

How much do you know about HER2 alterations in patients with non-small cell lung cancer (NSCLC)? Credit available for this activity expires: 3/31/2026 Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/1002375?ecd=bdc_podcast_libsyn_mscpedu

Helena Yu, MD and Joshua Sabari, MD explore the importance of testing for HER2 alterations in lung cancer; how HER2 positivity influences clinical decision-making; and the key methods used for detection, including immunohistochemistry, fluorescence in situ hybridization, and next-generation sequencing. It also addresses challenges in standardizing HER2 testing, disparities in access to biomarker testing, and the evolving role of liquid biopsy compared to traditional tissue biopsy.

Featuring an interview with Dr Sara A Hurvitz, including the following topics: Role of endocrine therapy in the management of HER2-positive breast cancer; implications of the Phase III PATINA study (0:00) Case: A woman in her mid 60s with node-negative, HR-positive, HER2-negative localized breast cancer and a Recurrence Score® of 28 (8:38) Available data guiding the selection of an adjuvant CDK4/6 inhibitor (12:49) Selection of a CDK4/6 inhibitor in the metastatic setting (23:16) Available therapies for patients with HR-positive metastatic breast cancer (mBC) and PIK3CA mutations; implications of the Phase III INAVO120 study (29:17) Case: A woman in her early 60s with HR-positive, HER2-negative mBC with short duration of benefit from a first-line CDK4/6 inhibitor and an aromatase inhibitor (AI) and coexisting PIK3CA and ESR1 mutations (37:11) Available data with approved and investigational oral SERDs (selective estrogen receptor degraders) (43:23) Case: A woman in her early 70s with HR-positive, HER2-negative mBC and an ESR1 mutation detected on disease progression after durable responses to first-line endocrine therapy and second-line CDK4/6 inhibitor with an AI (51:38) Selection of therapy for patients with HR-positive mBC and coexisting targetable genetic mutations (53:11) Case: A woman in her late 50s with HR-positive, HER2-negative mBC and an ESR1 mutation detected on disease progression after first-line CDK4/6 inhibitor with an AI (1:00:17) CME information and select publications