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Oral SERDs and PROTACs consolidated their place in ESR1-mutant disease, T-DXd de-escalation strategies matured in HER2+ early breast cancer, and the limits of giving one ADC straight after another became clearer.
Vepdegestrant improved progression-free survival versus fulvestrant in ESR1-mutant ER+/HER2- advanced breast cancer, with no benefit in ESR1-wild-type disease; the FDA approved it in Q2 2026, the first PROTAC degrader to reach market.
Imaging- and pCR-guided strategies allow selected HER2+ patients to receive less chemotherapy; T-DXd-based de-escalation was a central discussion.
SourceRetrospective series showed limited efficacy when a second ADC was given immediately after progression on a prior ADC, prompting discussion of interposing chemotherapy between ADC courses.
Datopotamab deruxtecan showed efficacy versus chemotherapy in first-line PD-L1-negative TNBC; the choice between Dato-DXd and sacituzumab govitecan was framed as patient-dependent (stomatitis and ocular events versus neutropenia and diarrhoea).
SourceDose-expansion data for patritumab deruxtecan showed activity in HR+/HER2-, HER2+, and triple-negative breast cancer.
In premenopausal HR+ early breast cancer, ovarian function suppression remained essential even as oral endocrine agents advance.
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