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Carlos Barrios is the most visible Latin American voice in global breast cancer trials and a founder of the region's cooperative group LACOG.
Carlos Barrios is a medical oncologist and Director of the Oncology Research Center at Hospital São Lucas PUCRS, a co-founder of the Latin American Cooperative Oncology Group (LACOG), and a collaborator with Hospital Israelita Albert Einstein and other major São Paulo centres. He has served on the steering committees of numerous global breast cancer trials and is the most visible Latin American voice in that field, having built LACOG to expand trial access across the region. His publications include analyses of trastuzumab emtansine in HER2-positive advanced breast cancer from the KAMILLA safety trial and a qualitative study of barriers to multidisciplinary breast cancer care in five Latin American countries. His interests are breast cancer, Latin American trials and global oncology.
Patients with hormone-receptor-positive metastatic breast cancer that has stopped responding to endocrine therapy can be offered trastuzumab deruxtecan as their first chemotherapy-type treatment if the tumour shows any HER2 staining, rather than waiting until after conventional chemotherapy. Whether to use it before or after chemotherapy is now a choice, since overall survival was not shown to differ and the drug carries a risk of lung inflammation.
Ribociclib is a second adjuvant CDK4/6 option, and the only one with data in node-negative stage II disease. Roughly 3 in 100 patients avoid a relapse or death at three years, so the decision depends heavily on individual risk, tolerance of a three-year oral drug, and cost. Whether the benefit persists after treatment ends, as it did with abemaciclib, needs longer follow-up.
For hormone-receptor-positive metastatic breast cancer that has already had chemotherapy, Dato-DXd controls the disease for longer with fewer severe side effects than chemotherapy, but does not help patients live longer, so it is not a standard option here. The result is a reminder that progression-free survival is a surrogate; regulators and clinicians should wait for survival data before adopting an ADC in a setting where later therapies are effective.
Shares TROPION-Breast01: datopotamab deruxtecan versus chemotherapy in pretreated hormone-receptor-positive breast cancer, and why a PFS win did not translate to survival, NATALEE: three years of ribociclib after surgery in a broad population of hormone-receptor-positive early breast cancer, DESTINY-Breast06: trastuzumab deruxtecan before any chemotherapy in hormone-receptor-positive, HER2-low or ultralow breast cancer, HR-positive / HER2-negative breast cancer.
Shares Pivotal trials include sites in Africa, South Asia and Latin America, sponsor-funded, Burden-matched funding for trials led in low- and middle-income countries, HR-positive / HER2-negative breast cancer.
Shares DESTINY-Breast06: trastuzumab deruxtecan before any chemotherapy in hormone-receptor-positive, HER2-low or ultralow breast cancer, HER2-positive breast cancer, HR-positive / HER2-negative breast cancer.
Shares TROPION-Breast01: datopotamab deruxtecan versus chemotherapy in pretreated hormone-receptor-positive breast cancer, and why a PFS win did not translate to survival, NATALEE: three years of ribociclib after surgery in a broad population of hormone-receptor-positive early breast cancer, HER2-positive breast cancer, HR-positive / HER2-negative breast cancer.
Shares Pivotal trials include sites in Africa, South Asia and Latin America, sponsor-funded, HR-positive / HER2-negative breast cancer.
Shares DESTINY-Breast06: trastuzumab deruxtecan before any chemotherapy in hormone-receptor-positive, HER2-low or ultralow breast cancer, HER2-positive breast cancer, HR-positive / HER2-negative breast cancer.
Shares NATALEE: three years of ribociclib after surgery in a broad population of hormone-receptor-positive early breast cancer, HER2-positive breast cancer, HR-positive / HER2-negative breast cancer.
Shares DESTINY-Breast06: trastuzumab deruxtecan before any chemotherapy in hormone-receptor-positive, HER2-low or ultralow breast cancer, HR-positive / HER2-negative breast cancer.