The Targeted Pulse: Blood and Breast Cancer News

Welcome to this week's edition of The Targeted Pulse, your weekly wrap-up of the top developments in oncology. This week, we had frontline access to the 2025 American Society of Hematology Annual Meeting and Exposition and the San Antonio Breast Cancer Symposium (SABCS), where we heard directly from leaders in the fields about the newest clinical innovations.

Poll Results Reveal Readers’ Top Abstracts at SABCS 2025

The Targeted Oncology reader polls highlighted several key breast cancer abstracts at SABCS 2025 for clinical attention.

In hormone receptor-positive (HR+), HER2-negative (HER2–) early breast cancer, the phase 3 lidERA study of the oral SERD giredestrant met its primary end point, demonstrating a statistically significant and clinically meaningful improvement in invasive disease-free survival (IDFS) over standard endocrine therapy.

However, the ASCENT-07 study in HR+/HER2– metastatic breast cancer did not meet its primary end point of progression-free survival (PFS) for sacituzumab govitecan (Trodelvy) vs chemotherapy.

For HER2-positive (HER2+) disease, HER2CLIMB-05 (tucatinib [Tukysa] combination) also met its primary end point of PFS. Additionally, safety and quality-of-life data from the ASCENT-04 trial of sacituzumab govitecan plus pembrolizumab (Keytruda) in triple-negative breast cancer will be presented. These abstracts represent important updates across breast cancer subtypes.

Teclistamab Plus Daratumumab Significantly Improves Survival in R/R Myeloma

The phase 3 MajesTEC-3 trial demonstrated that the combination of the bispecific BCMA-directed T-cell engager teclistamab and subcutaneous daratumumab (Tec-Dara) significantly improved outcomes in patients with relapsed/refractory multiple myeloma (R/R MM) who had 1 to 3 prior lines of therapy.

Compared to standard daratumumab-based regimens (DPd/DVd), Tec-Dara resulted in an 83% reduction in the risk of disease progression or death (median PFS not reached vs 18.1 months) and a 54% reduction in the risk of death (36-month overall survival [OS] rate, 83.3% vs 65.0%). The combination also achieved higher rates of complete response (81.8% vs 31.1%) and MRD negativity. The safety profile was manageable, supporting this regimen as a potential new standard –of care in earlier lines of R/R MM treatment.

ASCENT-07: Sacituzumab PFS Not Significant vs Chemo in HR+/HER2- BC

The phase 3 ASCENT-07 trial, investigating sacituzumab govitecanas first-line chemotherapy following endocrine therapy for patients with HR+/HER2– metastatic breast cancer, did not meet its primary end point of statistically significant improvement in PFS by blinded independent central review (BICR).

The median PFS by BICR was 8.3 months in both the sacituzumab and chemotherapy arms. Although an early, statistically significant trend favoring sacituzumab was observed for OS, the OS data are not yet mature (27% maturity). The sacituzumab arm did show higher rates of grade 3 or higher treatment-emergent adverse events (72% vs 48% for chemotherapy). Sacituzumab govitecan maintains its role as a standard of care in the post-chemotherapy setting based on the TROPiCS-02 study.

T-DXd Plus Pertuzumab Yields Favorable Benefit Over SOC in HER2+ Breast Cancer

Patient-reported outcomes from the phase 3 DESTINY-Breast09 trial comparing the antibody-drug conjugate trastuzumab deruxtecan (T-DXd; Enhertu) plus pertuzumab (Perjeta) against standard-of-care (taxane, trastuzumab [Herceptin], and pertuzumab) as a first-line therapy for HER2+ advanced/metastatic breast cancer, offer crucial clinical context.

While both regimens allowed for similar maintenance of physical function and comparable pain and fatigue control, the adverse effect profiles differed. The T-DXd plus pertuzumab arm was associated with more frequent gastrointestinal issues, but fewer skin/mucosal symptoms and extremity swelling. Overall, patients reported both regimens as similarly tolerable over time, supporting the use of T-DXd plus pertuzumab as an alternative first-line option.

Aromatase Inhibitors Favored as Adjuvant ET in HR+/HER2+ Early Breast Cancer

An exploratory, long-term analysis of the phase 3 ALTTO trial suggests aromatase inhibitors (AIs) are the preferred adjuvant endocrine therapy (ET) for patients with HR+/HER2+ early breast cancer.

With a median follow-up of 9.9 years, AI use was associated with an improved 10-year disease-free survival (DFS) rate of 80.1% vs 76.5% for selective estrogen receptor modulators (SERMs; aHR, 0.65). This benefit in DFS and time to distant recurrence was observed across menopausal subgroups and was achieved without compromising OS. In premenopausal patients, AIs with or without ovarian function suppression showed superior 10-year DFS compared with SERM-based regimens.