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This activity is provided by an independent medical education grant from Gilead Sciences, Inc.

The activity is jointly provided by USF Health and touchIME.

touchIME is an EBAC® accredited provider.

Faculty & Disclosures

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    Faculty & Disclosures
    Dr Alison Conlin

    Providence Cancer Institute, Portland, OR, USA

    Dr Alison Conlin is a medical oncologist and physician-researcher at the Providence Cancer Institute in Portland, OR, USA, where she leads the breast cancer programme in medical oncology. read more

    Dr Conlin specializes in the management of patients with breast cancer and high-risk breast conditions, with clinical expertise spanning both early and advanced stages of disease, including the development and integration of novel therapies for her patients.

    She completed her fellowship at Memorial Sloan Kettering Cancer Center, New York, NY, USA, following her residency at Weill Cornell Medical Center, New York, NY, USA. Her research interests focus on clinical trials and expanding access to innovative treatments for patients with all stages of breast cancer. She has been involved in clinical trials for patients with advanced breast cancer, including those with brain metastases, and has collaborated with organizations such as the American Cancer Society on cancer screening, prevention and survivorship care initiatives.

    Dr Conlin is recognized for her compassionate, patient-centred approach and her commitment to providing the highest standard of care. She is actively involved in national research consortia and continues to contribute to advancements in breast cancer treatment and patient outcomes.

    Dr Alison Conlin discloses Advisory board/panel fees from Arvinas, AstraZeneca and Stemline Therapeutics. Consultancy fees from Pfizer.
    Prof. Giuseppe Curigliano

    European Institute of Oncology and University of Milan, Italy

    Prof. Giuseppe Curigliano is the director of the Early Drug Development Division and co-chair of the Experimental Therapeutics Program at the European Institute of Oncology, a comprehensive cancer centre in Milan, Italy. read more

    Prof. Curigliano obtained his medical and specialist degrees from the Catholic University in Rome, Italy, and a PhD in Clinical Pharmacology from the University of Pisa, Italy.

    Prof. Curigliano is principal investigator and steering committee member for numerous breast and early-phase clinical trials, particularly involving innovative targeted compounds and individualized treatment strategies. His translational research focuses on biomarkers and personalized therapies, including biomarker discovery, the development of targeted agents and the implementation of personalized medicine. He leads phase I–III trials testing targeted agents in breast cancer, as well as agnostic and large national trials evaluating the implementation of high-throughput technologies in the healthcare system.

    Prof. Curigliano was recognized by Clarivate™ as one of  the world’s most influential researchers (highly cited researchers) in 2022, 2023 and 2024. He has authored more than 670 papers in peer-reviewed journals and many book chapters. He has served as an editorial board member for international oncology journals, including the European Journal of Oncology, the Journal of Clinical Oncology and the Annals of Oncology. Prof. Curigliano is a panel member of several international breast cancer consensus conferences and has served as chair or steering committee member for numerous national and international conferences. He has trained, mentored and sponsored many medical oncologists from Latin America, Africa, Asia and Italy.

    Prof. Curigliano was awarded the first European School of Oncology (ESO) Umberto Veronesi Award (2017) and was made a fellow of the European Academy of Cancer Sciences in Paris (2017). He is currently President-Elect of the European Society for Medical Oncology (ESMO) and Editor-in-Chief of ESMO Open.

    Prof. Giuseppe Curigliano discloses Advisory board/panel fees from AstraZeneca, Bristol Myers Squibb, Daiichi Sankyo, Exact Sciences, Gilead, Lilly, Menarini, Merck, Novartis, Pfizer and Roche (all relationships terminated). Consultancy fees from Ellipses Pharma (relationship terminated). Grants/research support from Merck (relationship terminated). Speakers’ bureau fees from AstraZeneca, Daiichi Sankyo, Exact Sciences, Gilead, Lilly, Menarini, Merck, Novartis, Pfizer and Roche (all relationships terminated).
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    What biomarkers do you use to help determine treatment for mTNBC?

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    PD-L1
       
    Germline BRCA1/2 mutation
       
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    Chest CT scan
       
    Chest X-ray
       
    Respiratory function test
       
    Patient reporting of symptoms
       
    All/combination or above
       

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    Breast cancer subtypes and biomarker testing
    Making informed treatment decisions for patients with HR+/HER2– mBC
    Practical advice for creating individualized treatment plans for patients with HER2+ mBC
    Effectively integrating ADCs into the treatment pathway for patients with TNBC
    Take CE/CME Test
    Breast Cancer CE/CME accredited

    touchIN CONVERSATION
    A relaxed discussion between two faculty focussed on real world clinical issues. Useful tips below will show how to navigate the activity. Join the conversation. Close

    Incorporating ADCs into the treatment of mBC: Practical considerations for the community oncologist

    Faculty Podcast Featured
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    Learning Objectives

    After watching this activity, participants should be better able to:

    • Explain how biomarkers, patient characteristics and clinical data can be used to personalize care, including the incorporation of antibody–drug conjugate (ADC) treatment where appropriate, for patients with HR+/HER2– metastatic breast cancer (mBC)
    • Apply strategies to develop effective individualized treatment plans, including the use of ADCs where appropriate, for patients with HER2+ mBC
    • Describe how ADCs can be integrated into the treatment pathway for patients with triple-negative breast cancer
    Overview

    In this activity, two oncologists (a breast cancer expert from an academic setting and an oncologist from a community setting), respond to questions from the oncology community on how to integrate ADCs into the treatment pathway for patients with mBC. The experts will discuss the use of biomarkers to help guide treatment, share practical insights into developing individualized care plans, and provide strategies for managing ADC-associated toxicities.

    This activity is jointly provided by USF Health and touchIME. touchIME is an EBAC® accredited provider. read more

    Target Audience

    This activity has been designed to meet the educational needs of oncologists, including community oncologists, involved in the management of patients with breast cancer.

    USF Accreditation

    Disclosures

    USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

    Faculty

    Dr Alison Conlin discloses: Advisory board/panel fees from Arvinas, AstraZeneca and Stemline Therapeutics. Consultancy fees from Pfizer.

    Prof. Giuseppe Curigliano discloses: Advisory board/panel fees from AstraZeneca, Bristol Myers Squibb, Daiichi Sankyo, Exact Sciences, Gilead, Lilly, Menarini, Merck, Novartis, Pfizer and Roche (all relationships terminated). Consultancy fees from Ellipses Pharma (relationship terminated). Grants/research support from Merck (relationship terminated). Speakers’ bureau fees from AstraZeneca, Daiichi Sankyo, Exact Sciences, Gilead, Lilly, Menarini, Merck, Novartis, Pfizer and Roche (all relationships terminated).

    Content reviewer

    Danielle Walker, DNP, APRN, AGNP-C has no financial interests/relationships or affiliations in relation to this activity.

    Touch Medical Contributors

    Hannah Fisher has no financial interests/relationships or affiliations in relation to this activity.

    USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

    Requirements for Successful Completion

    In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

    If you have questions regarding credit please contact cpdsupport@usf.edu 

    Accreditations

    Physicians

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

    USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Advanced Practice Providers

    Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

    The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

    Date of original release: 26 June 2025. Date credits expire: 26 June 2026.

    If you have any questions regarding credit, please contact cpdsupport@usf.edu

    EBAC® Accreditation

    touchIME is an EBAC® accredited provider since 2023.

    This program is accredited by the European Board for Accreditation of Continuing Education for Health Professionals (EBAC®) for 46 minutes of effective education time.

    EBAC® holds an agreement on mutual recognition of substantive equivalency with the US Accreditation Council for CME (ACCME) and the Royal College of Physicians and Surgeons of Canada, respectively.

    Through an agreement between the European Board for Accreditation of Continuing Education for Health Professionals (EBAC®) and the American Medical Association, physicians may convert EBAC® External CME credits to AMA PRA Category 1 Credits™. Information on the process to convert EBAC® credit to AMA credit can be found on the AMA website. Other health care professionals may obtain from the AMA a certificate of having participated in an activity eligible for conversion of credit to AMA PRA Category 1 Credit™.

    EBAC® is a member of the International Academy for CPD Accreditation (IACPDA) and a partner member of the International Association of Medical Regulatory Authorities (IAMRA).

    Faculty Disclosure Statement / Conflict of Interest Policy

    In compliance with EBAC® guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CME activities.

    Requirements for Successful Completion

    Certificates of Completion may be awarded upon successful completion of the post-test and evaluation form. If you have completed one hour or more of effective education through EBAC® accredited CE activities, please contact us at accreditation@touchime.org to receive your EBAC® CE credit certificate. EBAC® grants 1 CE credit for every hour of education completed.

    Date of original release: 26 June 2025. Date credits expire: 26 June 2027.

    Time to Complete: 46 minutes

    If you have any questions regarding the EBAC® credits, please contact accreditation@touchime.org

    This activity is CE/CME accredited

    To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

    Claim Credit
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    This Activity Is Funded By:

    An independent medical education grant from Gilead Sciences, Inc.

    The activity is jointly provided by USF Health and touchIME.

    touchIME is an EBAC® accredited provider.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgement of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Date of original release: 26 June 2025. Date credits expire: 26 June 2026.

    EBAC® 

    touchIME is an EBAC® accredited provider since 2023.

    In compliance with EBAC® guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CME activities.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 26 June 2025. Date credits expire: 26 June 2027.

    Claim Credit
    touchIN CONVERSATION
    Incorporating ADCs into the treatment of mBC: Practical considerations for the community oncologist
    0.75 CE/CME credit
    Question 1/5
    Based on the College of American Pathologists’ expanded spectrum for HER2 positivity, what is the definition of HER2-low breast cancer, as assessed by IHC and ISH?

    HER2, human epidermal growth factor receptor 2; IHC, immunohistochemistry; ISH, in situ hybridization.

    The College of American Pathologists’ template for reporting breast cancer biomarker test results was recently updated to include detailed characteristics of HER2 IHC and ISH result categories, as well as optional report comments that include definitions of HER2-low and -ultralow breast cancer, based on data from the DESTINY-Breast04 and DESTINY-Breast06 clinical trials. HER2-low is defined as an IHC score of 1+ or 2+/ISH–, and HER2-ultralow is defined as an IHC score of 0 (pattern 0+) with membrane staining that is incomplete and faint/barely perceptible in ≤10% of tumour cells.

    Abbreviations

    HER2, human epidermal growth factor receptor 2; IHC, immunohistochemistry; ISH, in situ hybridization.

    Reference

    College of American Pathologists. Available at: https://capatholo.gy/4jQ5Ikx (accessed 16 May 2025).

    Question 2/5
    You are considering treatment for a patient with HR+/HER2– (IHC 0) metastatic breast cancer, with no targetable genomic alterations. They have received two lines of ET and one prior line of chemotherapy in the metastatic setting. The patient switched to a different chemotherapy regimen 4 months ago, but their disease has now progressed. Which of the following would you recommend for your patient?

    ET, endocrine therapy; HER2, human epidermal growth factor receptor 2; HR, hormone receptor; IHC, immunohistochemistry.

    ESMO guidelines recommend that, for patients with HR+/HER2– metastatic breast cancer who are not candidates for ET or targeted therapy and have already received ≥2 lines of chemotherapy for advanced disease, sacituzumab govitecan should be considered (evidence level: I, B); datopotamab deruxtecan may be considered for these patients after one line of chemotherapy in the advanced setting (I, B).1 NCCN guidelines recommend sacituzumab govitecan for patients with endocrine-refractory advanced disease who are not candidates for trastuzumab deruxtecan (category 1, preferred); datopotamab deruxtecan is recommended in this setting for HER2-low, -ultralow or -null disease (category 2A).2

    Abbreviations

    ESMO, European Society for Medical Oncology; ET, endocrine therapy; HER2, human epidermal growth factor receptor 2; HR, hormone receptor; NCCN, National Comprehensive Cancer Network®.

    References

    1. Gennari A, et al. Ann Oncol. 2021;32:1475–95. ESMO Metastatic Breast Cancer Living Guidelines, v1.2 April 2025.
    2. NCCN Clinical Practice Guidelines in Oncology. Breast cancer. Version 4.2025 – April 17, 2025. Available at: www.NCCN.org (accessed 16 May 2025).
    Question 3/5
    What was the efficacy of trastuzumab deruxtecan in patients with HER2+ metastatic breast cancer with brain metastases, as reported in the DESTINY-Breast12 trial?

    CNS, central nervous system; HER2, human epidermal growth factor receptor 2; ORR, objective response rate; OS, overall survival.

    DESTINY-Breast12 was a prospective, non-comparative phase IIIb/IV trial that evaluated the activity of trastuzumab deruxtecan in patients with HER2+ metastatic breast cancer, including those with baseline BM (overall, n=263; stable, n=157; active, n=106) and without baseline BM (n=241). The confirmed CNS ORR was 72% in the overall BM cohort, 79% in those with stable BM and 62% in those with active BM. The 12-month OS rate in patients with baseline BM (90%) was similar to those without baseline BM (91%).

    Abbreviations

    BM, brain metastasis; CNS, central nervous system; HER2, human epidermal growth factor receptor 2; ORR, objective response rate; OS, overall survival.

    Reference

    Harbeck N, et al. Nat Med. 2024;30:3717–27.

    Question 4/5
    Your patient is receiving fourth-line trastuzumab emtansine for HER2+ breast cancer with active brain metastases, having already received trastuzumab deruxtecan, and local intervention with SRS is indicated. How do you approach this to balance efficacy and safety?

    HER2, human epidermal growth factor receptor 2; SRS, stereotactic radiosurgery; WBRT, whole-brain radiotherapy.

    Combining trastuzumab emtansine with SRS raises safety concerns due to a lack of robust evidence.1 A recent meta-analysis reported a 17% pooled incidence of grade ≥3 radionecrosis when trastuzumab emtansine was combined with brain SRS, higher than the 6–11% incidence after brain SRS alone.1 Retrospective studies have also demonstrated an increased risk of radionecrosis when SRS is delivered concurrently with ADCs.2–4 While robust data and consensus recommendations are lacking regarding the safety of combining ADC treatment and SRS for brain metastases in breast cancer, these results highlight a potential increased risk associated with combination therapy.1–3 Therefore, concurrent SRS and trastuzumab emtansine should be avoided in the absence of solid evidence.4

    Abbreviations

    ADC, antibody–drug conjugate; SRS, stereotactic radiosurgery.

    References

    1. Salvestrini V, et al. Radiother Oncol. 2023:186:109805.
    2. Koide Y, et al. J Neurooncol. 2024;168:415–23.
    3. Lebow ES, et al. JAMA Oncol. 2023;9:1729–33.
    4. Debbi K, et al. Cancers (Basel). 2023;15:2278.
    Question 5/5
    Your patient with TNBC (PD-L1-negative, germline BRCA1/2 wildtype, HER2-null) shows evidence of disease progression during first-line chemotherapy for metastatic disease. Based on current ESMO and NCCN guidelines, what is your next step?

    ESMO, European Society for Medical Oncology; HER2, human epidermal growth factor receptor 2; NCCN, National Comprehensive Cancer Network®; PD-L1, programmed death-ligand 1; TNBC, triple-negative breast cancer.

    For patients with PD-L1-negative, germline BRCA1/2 wildtype metastatic TNBC with disease progression on first-line chemotherapy, ESMO guidelines recommend second-line sacituzumab govitecan (I, A; preferred) or chemotherapy (I, B).1 NCCN guidelines also recommend sacituzumab govitecan for this patient population (category 1, preferred).2 Trastuzumab deruxtecan is recommended in the second-line setting for HER2-low disease (ESMO II, B; NCCN category 2A),1,2 which is not applicable here as this patient has HER2-null disease.

    Abbreviations

    ESMO, European Society for Medical Oncology; HER2, human epidermal growth factor receptor 2; NCCN, National Comprehensive Cancer Network®; PD-L1, programmed death-ligand 1; TNBC, triple-negative breast cancer.

    References

    1. Gennari A, et al. Ann Oncol. 2021;32:1475–95. ESMO Metastatic Breast Cancer Living Guidelines, v1.2 April 2025.
    2. NCCN Clinical Practice Guidelines in Oncology. Breast cancer. Version 4.2025 – April 17, 2025. Available at: www.NCCN.org (accessed 16 May 2025).
    Back to Activity

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    This Activity Is Funded By:

    An independent medical education grant from Gilead Sciences, Inc.

    The activity is jointly provided by USF Health and touchIME.

    touchIME is an EBAC® accredited provider.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgement of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Date of original release: 26 June 2025. Date credits expire: 26 June 2026.

    EBAC® 

    touchIME is an EBAC® accredited provider since 2023.

    In compliance with EBAC® guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CME activities.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 26 June 2025. Date credits expire: 26 June 2027.

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