The ASCO 2025 breast cancer updates revealed exciting changes in treatment for triple-negative breast cancer (TNBC) and HER2-low cases. For example, Dr. Sayeh Lavasani, MD, MSc, FRCPC, an Associate Clinical Professor and Breast Medical Oncologist at UC Irvine, shared key results from the ASCENT-04 and COMPASSHER2 trials during a spotlight session. Consequently, her talk showed how these findings could improve patient care with targeted, less invasive therapies. Whether you’re a doctor, patient advocate, or researcher, these breast cancer updates offer hope. Let’s explore Dr. Lavasani’s insights.
Better Neoadjuvant Therapy: COMPASSHER2 and HER2-Low Findings
First, the EA1181/CompassHER2 pCR trial stood out in the ASCO 2025 breast cancer updates. Specifically, it studied neoadjuvant taxane + Herceptin (TH) in 241 early-stage HER2-positive breast cancer patients, mostly Stage II (58% Stage IIA). Moreover, it used HER2Dx, a tool combining gene data and clinical factors, to predict pathological complete response (pCR) rates.
As a result, the trial found pCR rates of 4.8% overall (n=214), 7.3% in HER2-low negative or ultra-low positive groups, and 32.5% in IHC 3+ cases. Additionally, factors like low ER status (≤70%) and weekly paclitaxel (vs. every 3 weeks docetaxel) improved results. Thus, these findings suggest shorter, less intense chemotherapy options.
Dr. Lavasani highlighted the potential for tailored care:
“Patients could benefit from shorter duration because we can predict a higher rate of pCR in this patient population.” – Dr. Sayeh Lavasani
In short, this could mean less treatment burden for early-stage patients. For more, check the CompassHER2 results abstract.
[Image: Bar chart from Slide 4 showing pCR rates by subgroups; Alt Text: pCR rates in HER2-low subgroups from ASCO 2025 breast cancer updates]
ASCENT-04: A Breakthrough for Triple-Negative Breast Cancer
Next, the ASCENT-04/KEYNOTE-D19 trial took center stage in ASCO 2025 breast cancer updates for TNBC. For instance, this Phase 3 study compared sacituzumab govitecan (SG) + pembrolizumab against standard chemotherapy + pembrolizumab in untreated PD-L1-positive metastatic TNBC patients.
The results were clear: SG + pembrolizumab extended progression-free survival (PFS) to 12 months versus 7 months for chemo + pembro, with a hazard ratio of 0.65. Furthermore, duration of response (DOR) reached 16 months versus 9.2 months. Most subgroups benefited, except those previously treated with pembrolizumab, as most patients were new to immunotherapy.
Dr. Lavasani emphasized the advantage:
“Patients who were randomized to SG plus pembrolizumab did better. They had prolonged progression-free survival.” – Dr. Sayeh Lavasani
Therefore, this combo could become a new standard for TNBC, offering longer, better-quality lives. Read the full ASCENT-04 abstract.
[Image: Kaplan-Meier PFS curve from Slide 7; Alt Text: PFS comparison in ASCENT-04 trial from ASCO 2025 breast cancer updates]
New TNBC Treatment Roadmap: First-Line Shift for PD-L1+ Patients
Finally, ASCENT-04’s impact is reshaping TNBC care in the ASCO 2025 breast cancer updates. Previously, PD-L1-positive metastatic TNBC patients received chemo + pembrolizumab. Now, SG + pembro is the preferred first-line option, with PARP inhibitors for BRCA-mutated cases and clinical trials for others.
Because subgroup analyses showed broad benefits, this shift is gaining traction. Dr. Lavasani captured the change:
“After the results of ASCENT-04 presented at ASCO 2025, the roadmap will change. Now we expect that PD-L1 positive patients will be treated with SG plus pembrolizumab as first-line therapy.” – Dr. Sayeh Lavasani
As a result, patients may experience longer responses with fewer side effects. Explore the ASCO patient summary for a simpler explanation.
[Image: Decision tree flowchart from Slide 9; Alt Text: Updated TNBC treatment roadmap from ASCO 2025 breast cancer updates]
What’s Next for Breast Cancer Care?
In conclusion, the ASCO 2025 breast cancer updates point to a future of smarter, shorter treatments with COMPASSHER2 and a new TNBC standard via ASCENT-04. Dr. Lavasani’s insights show how tools like HER2Dx and trial results can personalize care. For example, doctors might start with PD-L1 testing for TNBC patients to apply these findings. What do you think of these changes?
Go to MOASC.org for more information.
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