The ESMO 2025 Congress, held October 17-21 in Berlin, will feature exciting breast cancer trials that could improve patient care. This countdown spotlights the top 10 trials, based on expert views and fresh data. Crafted for oncologists and healthcare workers, it includes antibody-drug conjugates (ADCs), CDK4/6 blockers, and survival results—giving practical tips for treatment.
10. 487MO: CDK4/6 Sequencing in HR+/HER2- Advanced Breast Cancer
Noor Wortelboer’s study compares first- and second-line CDK4/6 blockers, showing better overall survival (OS) with first-line use. Additionally, adjust sequencing for ESR1-mutated patients. Moreover, this trial is key to the lineup.
9. 555MO: Dato-DXd + Durvalumab in Unresectable TNBC
Phase 1b/2 BEGONIA data show progress-free survival (PFS) gains with datopotamab deruxtecan plus durvalumab, even in PD-L1-negative cases. Therefore, consider this for IO-naive groups. Furthermore, it’s a standout trial.
8. LBA18: DESTINY-Breast09 Subgroup Analysis
Trastuzumab deruxtecan with pertuzumab versus THP in first-line HER2+ metastatic breast cancer (BC) lowers PFS risk by 44%. Consequently, adapt this for high-risk subgroups. Also, it’s a vital part of the series.
7. LBA17: VIKTORIA-1 with Gedatolisib
Phase 3 results reveal PFS benefits with gedatolisib plus fulvestrant ± palbociclib in PIK3CA wild-type HR+/HER2- BC after CDK4/6 use. Thus, check resistance patterns. In addition, it adds value to the collection.
6. LBA14: NATALEE 5-Year Outcomes
Ribociclib plus NSAI in HR+/HER2- early BC keeps iDFS steady across high-risk groups. Moreover, tweak adjuvant length based on recurrence risk. Likewise, it’s an important study.
5. LBA13: monarchE OS Update
Adjuvant abemaciclib with endocrine therapy in high-risk HR+/HER2- BC notes the first CDK4/6 OS gain. Furthermore, handle diarrhea to ensure compliance. Also, it strengthens the set.
4. LBA15: Low-Dose Pembrolizumab in TNBC
Atul Batra et al.’s phase 2/3 trial boosts pCR rates with low-dose pembrolizumab plus anthracycline/taxane in neoadjuvant TNBC, cutting toxicity. Hence, use for high-risk cases. Similarly, it’s a key find.
3. LBA23: OptiTROP-Breast02
Sacituzumab tirumotecan beats chemo in pretreated HR+/HER2- BC, showing a PFS edge. In addition, assess for multi-refractory patients. Moreover, it’s a critical trial.
2. LBA20: ASCENT-03 in PD-L1-Negative mTNBC
Sacituzumab govitecan outshines chemo in first-line PD-L1-negative metastatic TNBC, delivering a PFS win. As a result, add to frontline plans. Furthermore, it’s a highlight.
1. 291O: DESTINY-Breast11 Neoadjuvant Trial
Trastuzumab deruxtecan ± THP versus standard care in high-risk HER2+ early BC leads with big pCR gains, topping expert interest. Finally, prepare for perioperative changes. Also, it’s a top pick.
Bonus: Presidential Choice:
LBA1 – DESTINY-Breast05 Adjuvant Trial T-DXd crushes T-DM1 with statistically superior iDFS (HR pending; interim data game-changing) in high-risk HER2+ early BC post-neoadjuvant residual disease. No new safety flags—could redefine adjuvant standards for 17K+ patients/year. Paired with DB-11, Enhertu owns early HER2+!
Why It Matters These trials, set for October 18-20 in Berlin’s CityCube, bring vital updates on neoadjuvant, adjuvant, and metastatic care. Stay ahead by using insights from these ESMO 2025 Breast Cancer Trials or the conference app.