Key Points:
• The treatment paradigms for early-stage TNBC, including the role Sacituzumab and radiation therapy.
• Insights from the SABCS 2024 conference, focusing on the keynote 522 regimen and its implications for neoadjuvant treatment.
• The management of locally advanced and metastatic TNBC, including the use of immunotherapy and the importance of PD-L1 testing.
• Strategies for managing toxicities associated with treatments like sacituzumab and T-DXd.
In this episode of the Oncology Brothers podcast, we dived deep into the evolving landscape of triple negative breast cancer (TNBC) treatment with our esteemed guest, Dr. Virginia Kaklamani from the UTHealth San Antonio MD Anderson Cancer Center. As we kick off 2025, we reflect on the significant advancements made in 2024, particularly in treatment algorithms and the standard of care for TNBC.
We began our discussion by exploring the treatment paradigm for early-stage TNBC, focusing on tumors less than two centimeters with no nodal involvement. Dr. Kaklamani emphasized the importance of patient discussions regarding chemotherapy, especially for smaller tumors, while outlining her approach for larger tumors and the ongoing debates surrounding anthracycline use.
Transitioning to locally advanced TNBC, we highlighted the impact of the Keynote 522 regimen, which incorporates immunotherapy and has shown promising results in achieving pathological complete response and overall survival. Dr. Kaklamani shared her standard approach for patients with two-centimeter or lymph node-positive disease, detailing the use of pembrolizumab and the considerations for patients who may not be candidates for immunotherapy.
In the metastatic space we discussed the role of PD-L1 testing and the treatment options available for de novo metastatic disease, including the sequencing of therapies like PARP inhibitors and antibody-drug conjugates. Dr. Kaklamani provided valuable insights into managing toxicities associated with these treatments, particularly with sacituzumab and T-DXd.
Throughout the episode, we emphasized the importance of navigating treatment decisions based on individual patient factors and the latest clinical data. We also recap key takeaways from the recent SABCS 2024 conference, reinforcing the need for ongoing education and adaptation in our clinical practices.
Join us as we continue to explore the complexities of oncology and the latest advancements in cancer treatment. Thank you for tuning in to the Oncology Brothers podcast!
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