Neil M. Iyengar, MD

ASCO 2026 spotlights metabolic health in cancer care, as GLP-1 obesity drugs show links to lower metastasis and survival gains, needing trials.

The faculty open the episode by discussing how most patients with hormone receptor-positive, HER2-negative metastatic breast cancer begin treatment with a CDK4/6 inhibitor plus an aromatase inhibitor and many respond well, sometimes for years.

The panel discusses a 52-year-old patient with metastatic TNBC including lung lesions and previously treated stable brain metastases, presenting for first-line treatment recommendations.

The panel reviews a 58-year-old patient with HR-positive, HER2-negative metastatic breast cancer progressing after endocrine therapy plus CDK4/6 inhibitor treatment. The patient has hepatic and bone metastases with radiographic and symptomatic progression, ECOG performance status 1, controlled hypertension, and mild dry eye syndrome. She prioritizes maintaining professional activity and independence.

Dr. Iyengar addresses common patient fears about vision loss, noting this represents a primary concern when discussing ocular toxicity. Dr. Sunshine provides reassurance that these represent reversible changes with appropriate monitoring and early intervention, emphasizing the importance of early detection through regular examinations.

Dr. Sunshine provides ophthalmologic perspective on Dato-DXd's unique ocular surface events, representing a new toxicity profile for breast oncology practitioners. The management approach begins with baseline patient education and ophthalmologic examination, establishing foundation for both patient awareness and professional monitoring.

Dr. Nunnery describes TROPION-Breast02 studying Dato-DXd in frontline patients with metastatic TNBC for patients ineligible for immunotherapy, similar to ASCENT-03 design but with important differences in eligibility criteria.

Dr. Nunnery discusses ASCENT-07, which moved SG earlier in the treatment sequence for HR-positive disease, allowing patients progressing on endocrine therapy to receive the ADC immediately rather than requiring intervening chemotherapy. Surprisingly, this frontline comparison against standard chemotherapy yielded negative results without statistically significant PFS improvement.

New ADC trial data reshapes metastatic breast cancer care: why OS differs, where T-DXd fits, and SG’s frontline gains in TNBC.

Experts unpack new antibody-drug conjugate trial data, sequencing choices, and toxicity management reshaping metastatic breast cancer care.

Explore how ADCs, ctDNA monitoring, and new endocrine options reshape metastatic breast cancer care, as well as sequencing and toxicity tips from experts.

As the journal ONCOLOGY reaches it's 40-year anniversary, it's important to reflect on the transformation of cancer care in that time, according to Julie M. Vose, MD, MBA, and Neil M. Iyengar, MD.

Read about recent advancements in breast cancer treatment, including new therapies and survival data, showcased at the upcoming ESMO 2025 Congress.

Patients with breast cancer experience significant weight loss after using GLP-1 receptor agonists, highlighting potential benefits for obesity management in this population.

Exercise significantly enhances cancer treatment outcomes, improving survival rates and quality of life for patients with colon cancer who have completed therapy.

Neil M. Iyengar, MD, highlighted the recent T-DXd and Dato-DXd approvals in breast cancer.

Neil M. Iyengar, MD, discussed the most prevalent discussions and exciting updates from the 2025 Miami Breast Cancer Conference.

Panelists discuss advice for nurses collaborating with oncologists in treating patients with HER2+ breast cancer, as well as closing messages for patients receiving treatment and clinicians involved in the care of those with advanced HER2+ breast cancer.

Panelists discuss emerging regimens and agents being explored for the future treatment of advanced HER2+ breast cancer, highlighting the potential innovations that may improve patient outcomes.

Panelists discuss key aspects of supportive care that aided a patient's journey, including the impact of her primary caregiver's support, the sources of strength drawn from personal, spiritual, or community connections, and the roles of integrative medicine and nutrition in her treatment experience.

Panelists discuss the supportive care considerations for patients being treated for metastatic HER2+ breast cancer, including the roles of nutrition, exercise, and other integrative approaches in enhancing patient well-being and treatment outcomes.

Panelists discuss the adverse effects experienced by a patient undergoing treatment with capecitabine (Xeloda), trastuzumab (Herceptin), and tucatinib (Tukysa), along with the strategies employed to manage those adverse effects, while also addressing patient follow-up procedures, including the frequency of visits, typical labs and imaging ordered, concerning symptoms and lab results, and the outcomes of the patient's most recent follow-up appointment.

Panelists discuss how patients are prepared for treatment, the adverse effects associated with different agents and combination regimens that they educate patients about, the process of administering treatment for HER2+ breast cancer, and the overall approach to monitoring and managing adverse effects throughout the treatment journey.

Panelists discuss the progress of the BRIDGET trial and its potential impact on HER2-positive breast cancer patients, focusing on the anticipated data and its implications for treatment strategies in this population.

Panelists discuss a brief overview of recent data on combination systemic therapies for the treatment of advanced HER2+ breast cancer, including studies such as DESTINY-Breast03, DEBBRAH, HER2CLIMB-02, and EMILIA, and they analyze which patient populations may benefit most from each therapy option based on the available data.

Neil M. Iyengar, MD, highlights the biggest advances in oncology, and where he expects the field to move next.

Panelists discuss key data from the HER2CLIMB study, which evaluates the efficacy of tucatinib (Tukysa) in combination with trastuzumab (Herceptin) and capecitabine (Xeloda) for patients with advanced HER2+ breast cancer, highlighting outcomes across patient subgroups and the clinical significance of findings related to patients with measurable baseline intracranial disease.

Panelists discuss a high-level overview of systemic therapies for advanced HER2+ breast cancer, outlining the roles of HER2-targeted monoclonal antibodies, tyrosine kinase inhibitors (TKIs), and antibody-drug conjugates (ADCs) in treatment, as well as treatment strategies for patients with brain metastases. They also explore the shared decision-making process that informed the recommendation of the HER2CLIMB regimen.