Too tired to post more from the conference except this selfie with the incredible @MammaMiaMagazin!! This woman spoke about dealing with side effects and went to the mic to remind the docs that we patients should be on the stage too, because we’re taking the drugs #ESMOBREAST24
Now at #esmobreast24 it’s #BrainMets. Should we routinely screen? I know most MBC patients would say 👍🏻. Dr Emilie Le Rhun provides @myESMO guidelines. Brain mets are more common in HER2+ & TNBC, but can also occur in ER+. Brain mets also tend to occur sooner in TNBC.
And apparently it has a name now, supplied by discussant Dr Yoo -Sim Yap (no relation): atirmociclib! #ESMOBreast24
Dr Timothy Yap #esmobreast24 mini-oral abstract on IND CDK4 inhibitor PF722 (@PfizerOncMed drug). Pts had prior CDK4/6i & prior fulvestrant. Side effects were mainly 🩸 18% grade 3 neutropenia; diarrhea 🚽 but almost all grade 1; nausea, again mainly grade 1.
Dr Martina Schmidt at #esmobreast24 mini-oral abstract on the impact of exercise on sexual health in 🚺 w/ MBC showed a definite benefit. Maybe instead of “use it or lose it” we should promote “move it or lose it”. #bcsm
Dr @matteolambe discusses this mini-oral abstract presentation. This gym has 🙋🏼♀️ : in the French trial, estriol or promestriene but in the US we usually use estradiol. Does this make a difference? Would love to see trials, including in MBC, using estradiol. #ESMOBreast24 #bcsm
Dr Elise Dumas on vaginal estrogen after an early stage BC dx. I think some of these findings would be applicable to MBC - as we live longer we may want to have functioning vaginas! But, if on an AI, recurrence risks were slightly ⬆️#esmobreast24
It’s always wonderful to see fellow #advocates at meetings like #ESMOBreast24, especially ones like @annmcbrien_ from my ancestral home of 🇮🇪!
The livestream stopped before Dr @hoperugo did, so I had to capture her final slide the old fashioned way 📸. Her tribute to her mom, who died from MBC, and her family was incredibly moving.
She is a remarkable oncologist and human and I am lucky to be her patient.
#ESMOBreast24
Liquid biopsy ctDNA has a role in both early and metastatic breast cancer, with some treatments recommended on the basis of ctDNA and ongoing trials looking at acting on ctDNA findings before imaging indicates progression.
#ESMOBreast24
What about combining ADCs and immunotherapy? There have been trials but my first thought is 😱 the side effects! #ESMOBreast24
Dr @hoperugo spoke about ADCs, reviewing recent trials demonstrating their efficacy. She was instrumental in studies and guidelines to address some of the toxicities associated with them. #ESMOBreast24
With immunotherapy in HR+ MBC there was about 20% of patients who benefitted, which doesn’t sound great, but there was a 12 month duration of response with pembrolizumab alone
#ESMOBreast24
Immunotherapy hasn’t been the blockbuster in MBC that it has been in other cancers BUT there is hope. Immunotherapy is a research interest of Dr @hoperugo #ESMOBreast24
My brilliant (and caring) MBC expert oncologist Dr @hoperugo receives the ESMO Breast Award for her outstanding contributions
#ESMOBreast24
We need support to address our needs! And @MammaMiaMagazin has an incredible avatar game!! 👏🏻 #ESMOBreast24
And the regimens we have to follow to take our oral tx (& the drugs to address the side effects of the treatments!) can be impossible. And then what we can and can’t eat! I’ve never craved grapefruit as much as I did when I was on. CDK4/6i. It is a vicious cycle 🔄 #ESMOBreast24
Eva Schumacher-Wulf @MammaMiaMagazi brings the important person-actually-taking-these-drugs perspective to the discussion of toxicities at #ESMOBreast24
While most of the talk was focused on early stage disease, there was a pilot study in HER2- MBC but with HER2+ CTCs - adding lapatinib improved outcome. #ESMOBreast24
Dr @hthrparsons speaking about MCED (multi cancer early detection) test - the horse is miles and miles away from that barn for me, but I do have a daughter…..
#ESMOBreast24
I’m on a Phase1b clinical trial - investigational palazestrant + ribociclib. There’s a poster here and I think I found myself!!
I think this is a promising combo. I have scans 🩻 again Monday so keep your 🤞🏻 that I’m still stable, or even better, showing a ⬇️ SUV
#ESMOBreast24
Another reminder: in order to go on capivasertib (Trucap - where do they get these names 🤷♀️) on must have a mutation of PIK3CA, PTEN, AKT pathways. Diarrhea 🚽 and rash 😩 are the most common side effects, but hyperglycemia 🍭 is lower than with alpelisib. #ESMOBreast24
Bottom line: many patients who develop ILD can resume TDXd and may achieve a meaningful benefit. #ESMOBreast24
Most patients were able to restart TDXd, many without a dose reduction, and while 1/3 did develop a 2nd ILD 🫁 75% were able to resume TDXd #ESMOBreast24
What about emulating a randomized trial when designing an observational real world data or pragmatic trial? The trial can be mimicked in RWD analysis, as in this example with paclitaxel +/- bevacizumab #ESMOBreast24
What about single arm vs randomization? Adding real world data? All these come with statistical questions. What about bias, confounding factors when the population is more heterogeneous in terms of things like prior LOTs, comorbidities? #ESMOBreast24
