Maria Hafez

Day 3 #ESMO26: @jhaveri_komal on refining adjuvant ET in ER+ EBC
✅ CDK4/6i: durable iDFS; OS benefit w/ abema, trend w/ ribo
🆕 lidERA: 1st positive adjuvant oral SERD (HR 0.70)
🧬 ctDNA/MRD: next frontier
🎯 Right drug, right time, right patient
#BCSM #SLUHN 
📋 If giredestrant is approved and CDK4/6i isn't an option (access, toxicity, preference), she'd strongly consider it. Stage I higher-risk: select cases. Stage II–III: CDK4/6i first, SERD after? Sequential trials read out from 2027. #OralSERD #BCSM 
🏎️ ctDNA is like F1 telemetry: a real, early signal. In monarchE, 4-yr iDFS was 87.5% with persistently negative ctDNA, and 93% of patients whose ctDNA turned positive had an event. Does an early "pit stop" help? AFT-70 NAVIGATE is testing that. #ESMO26 #SLUHN 
👩 In patients ≤40, CDK4/6i benefit held: iDFS HR 0.60 (monarchE) and 0.55 (NATALEE). No biomarker yet identifies who won't benefit. #BCSM #EndocrineTherapy @OncologyNetwork @JIPOEditors @myESMO @oncodaily

💉 Day 3 #ESMO26: Prof @shigehira on IO in HR+/HER2− early BC
📈 KN-756 & CM-7FL: ~10-pt pCR gain
🎯 Signals: ER-low, PD-L1+, high TILs, MP High2
⚠️ irAEs like TNBC; EFS pending
💡 pCR gain alone doesn't yet justify ICI
#BCSM #SLUHN #Immunotherapy Optional reply tweet ☢️ Neo-CheckRay (phase II): tumor SBRT may turn PD-L1-negative tumors "hot". pCR rose from ~3% to ~30% in PD-L1 <1% disease with SBRT + ICI. Small trial, so this is hypothesis-generating. 👀 SWOG S2206 (MP High2, EFS endpoint) is the trial to watch. #ESMO26 #BCSM #SLUHN @OncologyNetwork @JIPOEditors @mystlukes @oncodaily @myESMO

🧬 Day 3 #ESMO26 take-homes from @MOliveira_MD , early HR+/HER2− BC:
1️⃣ Stage carefully, clip nodes before therapy
2️⃣ Surgery + genomic score: standard for cT1-2 cN0-1
3️⃣ Ki67 after 2–4 wk ET adds info
4️⃣ Young women: the ET given matters as much as biology
#BCSM #SLUHN 5️⃣ ET-sensitive tumors rarely reach pCR with chemo, even if clinically high risk. Can CDK4/6i + ET fill the gap? 🔬 NoLEEta is asking. Survival, not pCR, will decide. #ESMO26 #BCSM #SLUHN @OncologyNetwork @JIPOEditors @mystlukes

🎗️ #ASCO26 Day 1 - Breast Cancer Update "Endocrine Therapy in Metastatic Breast Cancer: Still the Foundation, or Time to Move On?" Alexandru Eniu, MD, PhD (Genolier Cancer Center, Switzerland · FESMO · ASCO Ambassador) The verdict: endocrine therapy hasn't been replaced, it's been re-engineered. In a decade, we went from 4 agents (2015) to 13+ targeted agents (2026), and the real challenge has shifted from what we CAN give to what we SHOULD give, and WHEN. Key points I'm taking back to clinic 👇 🔹 ET is still the backbone for most HR+/HER2− MBC, but the backbone now carries CDK4/6i, PI3K/AKT inhibitors, oral SERDs, and the first PROTAC (vepdegestrant). 🔹 Resistance is a continuum, not a binary (new ABC8 definitions): ET-naïve → late acquired → early acquired → primary → endocrine insensitivity. Where the patient sits predicts ET benefit and when to pivot to ADC/chemo. 🔹 Biomarker-directed options matter: INAVO120 (Inavolisib + palbo + fulv) showed an OS benefit in PIK3CA-mut early secondary resistance; capivasertib (CAPItello-291) broadened the PI3K/AKT/PTEN target; imlunestrant (EMBER-3) brought an OS signal + brain penetrance in ESR1-mut. 🔹 Framework over algorithm: Biology → Disease kinetics → Prior therapy → Patient → Access. Every progression is a new decision: retest (ctDNA preferred), reassess goals, and reapply the framework. 🔹 Access is the dose-limiting step. Only 22% of patients globally have full access to all 5 drugs + diagnostics. Drug access without diagnostic access = precision oncology in theory only. The takeaway that stuck with me: the skill is no longer knowing the drugs, it's matching the right one to the right patient at the right time. 💙 @asco @oncdaily #BreastCancer #OncologyTwitter #PrecisionOncology #MetastaticBreastCancer #HRpositive #MedicalOncology #ASCO #SLUHN

From #ESMOBreast Berlin, the key message in HR+/HER2. metastatic breast cancer is no longer simply “what is next after CDK4/6 inhibitor?” It is how do we sequence intelligently. With overlapping approvals, we need to match biology to treatment: ✅ ESR1-mutant disease → oral SERDs ✅ Endocrine-sensitive disease → targeted combinations ✅ Endocrine-refractory / chemo-refractory disease → ADCs ✅ Emerging space → CDK2/4/7, KAT6 inhibitors, PROTACs, radioligand therapy The field is moving fast, but the biggest unmet need remains clear: better biomarkers to guide selection, sequencing, and timing. Precision in HR+ breast cancer is becoming less about adding more options , and more about choosing the right option at the right moment. #BreastCancer #ESMOBreast2026 #HRPositiveBreastCancer #MetastaticBreastCancer #Oncology #ClinicalTrials

#SABCS2023 Good news for young BRCA patients who want to get pregnant 👏 For more details 👇 jamanetwork.com/journals/jam… @SABCSSanAntonio @KimmelCancerCtr

#SABCS2023 More exciting news for mHR+ve patients with TROPION BREST01. Dato-Dxd, after 1-2 lines of therapy, improved - PFS 6.9 vs 4.5 mo (HR 0.64) comparing to chemotherapy Not only that, 💊The time for subsequent treatment is 8.2 vs 5.0 mo. 🩺 Less side effects with Dato 💪🏻 better quality of life. More choices! More Hope! @SABCSSanAntonio @AACR @OncLive @KimmelCancerCtr