2) Our first #tweetorial comes from the San Antonio Breast Cancer Symposium (#SABCS21) which just wrapped up over the weekend–only the most current updates for OUR followers! Our expert author is Hal Burstein MD (@drhburstein) from @DanaFarber Cancer Institute & @HarvardMed pic.twitter.com/aokHqFjQUT
— @onc_ce (@onc_ce) December 14, 2021
4) @SABCSSanAntonio is a primary international scientific symposium for interaction and exchange among basic scientists and clinicians working in #breastcancer. #SABCS21 was a hybrid meeting this year, with many renowned researchers welcoming the opportunity to collaborate FTF!
— @onc_ce (@onc_ce) December 14, 2021
6) There was a great deal of attention this year to treatment of #HER2+ & triple-negative breast cancer, in large part because of advances in the use of antibody-drug conjugates (#ADCs). For those not fully familiar with #ADCs, they are immunoconjugates comprised of a … pic.twitter.com/qNXSpuTzQ9
— @onc_ce (@onc_ce) December 14, 2021
8) … minimizing toxicity to normal tissue & achieving wider therapeutic windows w/ enhanced #pharmacokinetic/#pharmacodynamic properties. For example, the #ADC trastuzumab deruxtecan (#TDxD) was featured in several studies presented at #SABCS21.
— @onc_ce (@onc_ce) December 14, 2021
10) … pretreated patient population with #HER2-positive metastatic breast cancer. In the DESTINY03 trial, TDxD had better RR, PFS, and OS than TDM1 (https://t.co/gGTWasjaH9).
— @onc_ce (@onc_ce) December 14, 2021
12) A new study from @nlinmd and @SKabrajiMD at @danafarber, presented at #SABCS21 showed that trastuzumab deruxtecan achieved a remarkable 73% response rate in brain mets in patients with refractory #HER2+ #metastaticbreastcancer (#MBC) previously treated with TDM1. pic.twitter.com/aMsSkNRWZw
— @onc_ce (@onc_ce) December 14, 2021
14) The natural history of HER2+ CNS mets appears to be much different than in the past. There was also progress with leptomeningeal disease, which remains a clinical challenge for HER2+ MBC. The @TheTBCRC Trial 049 showed that median OS for patients with …
— @onc_ce (@onc_ce) December 14, 2021
16) … HER2+ leptomeningeal disease. #Tucatinib achieved therapeutic levels in CSF. pic.twitter.com/S5Rw7TExhe
— @onc_ce (@onc_ce) December 14, 2021
18) This is very close to the risk reduction previously seen in DESTINYB-03 clinical trial. In this registry the rate of interstitial lung disease (#ILD) among TDxD-treated patients was 3.7%.
— @onc_ce (@onc_ce) December 14, 2021
19b)
— @onc_ce (@onc_ce) December 14, 2021
c. Because of the blood brain barrier, ADCs cannot be active against HER2+ CNS metastases
d. Tucatinib levels can be detected in the CSF of treated patients
21) Welcome back to our #accredited #tweetorial on highlights of new HER2+ #metastaticbreastcancer from #SABCS21. I am @drhburstein and you have found your new, ONLY source for oncology CE/#CME by tweetorial! Thanks for joining! Hello to @cancermedic @VaughtPhD @OmarOnco
— @onc_ce (@onc_ce) December 15, 2021
23) BBB peptide shuttles may help #ADCs cross into the brain (see https://t.co/k0ctj4v1pL). It is thought that HER2+ tumors are more likely in the CNS because of a predilection for visceral sites, & because the CNS remains a relative sanctuary site for tumor control.
— @onc_ce (@onc_ce) December 15, 2021
25) Trastuzumab deruxtecan (#TDxD) is also being studied in tumors by varying HER2 status. #DAISY study looked at TDxD in 3 cohorts: HER2+, HER2 low (1+/2+), & HER2 neg. Response rate results: HER2+ 69%, HER2 low 33%, HER2 neg 30%. @PTarantinoMD suggests we need novel . . .
— @onc_ce (@onc_ce) December 15, 2021
27) Progression-free survival (PFS) was HER2+ 11.1m, HER2 low 6.7 m, HER2 neg 4.2 m. This is intriguing activity, especially in the HER2 low, ER pos subset. This sets the stage for a #RCT to compare #TDxD vs chemo.
— @onc_ce (@onc_ce) December 15, 2021
29) High early relapse (by 5yrs), but rare by 5-15 yrs (<3%). She separately reported on a subset of African-American (AA) patients in the #ASCENT RCT (https://t.co/sKpAgqqSnM) with Sacituzumab govitecan (#SG) vs standard chemotherapy in #TNBC.
— @onc_ce (@onc_ce) December 15, 2021
31) Also, there's a new #ADC w/potential in #TNBC. Datopotamab deruxtecan (#Dato-DxD) is an anti-TROP2 ADC w/ a topo 1 inhibitor payload. At #SABCS21 we learned of #TROPION-PanTumor01 outcomes in pretreated #mTNBC. #IanKrop & @dradityabardia reported an overall RR of 34% & … pic.twitter.com/LAwJRpX47m
— @onc_ce (@onc_ce) December 15, 2021
33) The authors reported that the most common #AEs with #Dato-DxD were nausea, stomatitis, vomiting, fatigue, & alopecia. Larger studies are underway. pic.twitter.com/GsYPeu99Mt
— @onc_ce (@onc_ce) December 15, 2021
35) #TDxd was the big story of 2020/early 2021 for HER2+ ; it's moved to recommended 2nd line therapy and might even become 1st line. New data on #ADC SYD985 and TKI pyrotinib are interesting as well. pic.twitter.com/JylYL9OxX2
— @onc_ce (@onc_ce) December 15, 2021
37) And that's it! You can now go claim your FREE CE/#CME at https://t.co/AziUkVdfMo and FOLLOW US for more #accredited programs for #physicians #pharmacists #nurses. I am @DrHBurstein. Tip o' the hat to @SABCSSanAntonio for a GREAT 2021 show!
— @onc_ce (@onc_ce) December 15, 2021