Dr Sarah Sammons

Tremendous discussion by @drsarahsam, highlighting the promise of several escalation/substitution strategies across breast cancer subtypes, but reminding the costs and caveat of each new option. #ASCO26 https://t.co/jK1KB3bnHq

#ESMO2026, my read. What changes my practice, and what doesn’t yet. #BreastCancer OptiTROP-Breast01: OS HR 0.60, and the gap held despite crossover to TROP2 ADCs. In TNBC, the ADC goes early. BRIDGET: isolated brain progression in HER2+, local therapy plus tucatinib, keep the backbone. Single arm, historical control, but I’d use it. @drsarahsam NATALEE OS: HR 0.81, nominal. iDFS remains the proven benefit. Paired biopsies after T-DXd: HER2 rarely lost, efflux and uptake change instead. A repeat biopsy that only re-checks HER2 explains little. #Endometrialcancer TroFuse-005: sac-TMT beat doxorubicin or weekly paclitaxel after chemo-IO, PFS HR 0.59, with an OS benefit reported. First ADC with survival in endometrial cancer. I want the subgroups before I call it for everyone. KEYNOTE-C93: pembro alone vs chemo in dMMR, PFS HR 0.57, OS not significant. Real option for patients avoiding chemo. But about 20% progress early, and we can’t identify them upfront. GY020: negative and underpowered. Radiation alone stays my standard in early-stage dMMR. DUO-E: in pMMR, durvalumab OS HR 0.95. Olaparib bought PFS with twice the grade ≥3 toxicity. Never tested against durvalumab alone. #Ovariancancer RAINFOL-02: rina-S OS HR 0.43 without FRα selection. Press release only so far. If it holds, FRα stops being the gate. The next question is whether it works earlier. I am bringing the first-line maintenance trial of rina-S to @NorthwellHealth, for newly diagnosed non-HRD ovarian cancer, where PARP inhibitors help least. BEHOLD-1: response tracked with linker cleavage and TOP1, not B7-H4 level. Exploratory, but it changes what the next biomarker should measure. #ctDNA Positive means risk. One negative draw means little. >>>Most of what we saw improves PFS. Fewer trials improved survival, and almost none told us who benefits. That’s the work now. @myESMO @OncoAlert #ESMO26 #bcsm #gyncsm

Fantastic data by @drsarahsam in #BRIDGET showing the activity of #tucatinib in pts with 🧠 mets....used in combo w/ standard therapies..building upon what we saw in HER2CLIMB. ⬆️ unmet need! #ESMO26 #ESMOAmbassadors @OncoAlert https://t.co/1Rw2hsE4dh

BRIDGET trial beautifully presented by @drsarahsam Adding tucatinib to HP after local therapy for isolated intracranial progression improved PFS in HER2+ MBC @OncoAlert #ESMO26 https://t.co/vIduedfDFh

At #ESMO26 Rapid oral abstracts session on advanced #breastcancer @drsarahsam presents BRIDGET 🧠 Adding tucatinib to Trastuzumab/Pertuzumab in HER2+ mBC with isolated intracranial progression ⬆️ brain disease control after local tx Rare extracranial PDs (n=2) @OncoAlert https://t.co/pu2vnxWAHZ

BRIDGET Trial (Phase II) #ESMO26 @drsarahsam Adding tucatinib after local therapy for isolated CNS progression in HER2+ metastatic breast cancer demonstrated durable intracranial control. 18-month intracranial PFS: 59% 18-month extracranial PFS: 98% Promising strategy for isolated CNS progression.

Major FDA news today for early-stage HER2+ breast cancer. T-DXd approved for two separate indications: neoadjuvant Stage II/III disease (T-DXd x4 followed by THP x4), and adjuvant treatment for residual invasive disease after neoadjuvant HER2-targeted therapy. The data are striking. DESTINY-Breast11: pCR 67.3% vs 56.3% with ddAC-THP (p=0.003). DESTINY-Breast05: 3-year IDFS 92.4% vs 83.7% with T-DM1, HR 0.47 (95% CI 0.34-0.66, p<0.0001). But the real work is just beginning. Not every high-risk patient needs T-DXd upfront. Our challenge as oncologists is figuring out who needs what. Biomarker-driven selection, ctDNA, pCR response – these questions have to follow. Escalation and de-escalation strategies needed. #bcsm #BCSM #BreastCancer

My favorite study today at #ESMOBreast: PREcoopERA (IBCSG 67-22), a window-of-opportunity trial in premenopausal ER+/HER2- early BC asking whether giredestrant alone is enough, or whether ovarian suppression is still required. 231 patients → giredestrant alone, G + triptorelin, or anastrozole + triptorelin. Primary endpoint: Ki67 at 4 weeks. Giredestrant alone did NOT meet non-inferiority vs G+OS (-68% vs -80%). And G+OS was not superior to anastrozole+OS (p=0.18). Bottom line: Even for a next-gen SERD, ovarian suppression adds to anti proliferation effect in premenopausal patients. #ESMOBreast #BreastCancer #Giredestrant

Post-CDK4/6i, PIK3CA-WT HR+/HER2- MBC: how does gedatolisib stack up to other options? PFS by regimen: Everolimus + ET: 5.5 mo Oral SERD alone (ESR1m): 5.5-8 mo Abema + imlunestrant: 10.9 mo Gedatolisib + fulv: 7.4 vs 2.0 mo, HR 0.33 Gedatolisib + fulv + palbo: 9.3 vs 2.0 mo, HR 0.24 Not a clean cross-trial comparison, different populations and control arms. Clearly looks better than everolimus combo, though this should have been control. #bcsm May use doublet in ESR1 and PIK3CA WT who don’t mind IV therapy.

We are so excited to present the results of this unique but present population of isolated brain progression in HER2+ breast cancer. #bcsm https://t.co/TSbUfvagAF

Tucatinib added to HP is a nice option for 1L low volume brain only disease after local therapy. Particularly in patients with no extracranial disease where the toxicity of ADC is not desired. #ESMO26 https://t.co/ILYOutcThH