Research To Practice | Oncology Videos Breast Cancer — Proceedings from a Multitumor Symposium in Partnership with Florida Cancer Specialists & Research Institute
Nov 10, 2025
Dr Rita Nanda, expert in endocrine-resistant HR+ disease and targeted agents. Dr Harold J. Burstein, HER2 specialist with expertise in neoadjuvant and metastatic strategies. Dr Heather McArthur, authority on triple-negative disease and ADCs. Dr Matthew P. Goetz, investigator in HR+ and CDK4/6 research. They discuss genomic assays, sequencing of CDK4/6 and PI3K/AKT agents, ADC selection and toxicities, HER2 strategies, and ctDNA applications.
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Prioritize ADC Choice And Monitor Toxicities
- Sequence ADCs and conventional chemo thoughtfully; prioritize the ADC most likely to work first based on tumor subtype and toxicity.
- Monitor for common ADC toxicities (ILD with TDXD, neutropenia/diarrhea with SG, ocular/stomatitis with DatoDXD) and manage proactively.
TDXd Shifts Earlier In HER2 Care
- Trastuzumab deruxtecan is moving from refractory to earlier HER2-positive settings including neoadjuvant and adjuvant residual disease.
- Optimal timing (upfront vs reserve) remains unresolved and will depend on trial readouts and ILD risk balance.
Favor Active Systemic Drugs For Brain Mets
- For HER2+ brain metastases, favor the most active systemic agent (often TDXD) and defer whole-brain radiation if limited lesions can be managed locally.
- Expect systemic drugs that work outside the brain to often work intracranially as well.