🧐 A 75yo ♀️w/ ER+/HER2- PIK3CA+ mBC is starting 2L therapy with alpelisib + fulvestrant. Baseline A1C is 6.1 and BMI is 33. What steps can limit risk for severe hyperglycemia❓

#PostTest Q1️⃣ #TumorBoardTuesday 👉🏽#CME Eval 🔗 integrityce.com/TBTeval24 👉🏽ALL CME🔗 integrityce.com/TBT2024

18/18 #TumorBoardTuesday 👩🏻‍🏫Mini Tweetorial 12🏫 🔊Take home points 🔊: ✅ Liquid biopsy recommended at progression on 1L to screen for mutations ✅ 2L options have mPFS 5-11 months, some with OS benefit ✅ Optimal sequence unknown at this time, likely depends in part on patient factors

17/18 #TumorBoardTuesday 👩🏻‍🏫Mini Tweetorial 11🏫 Ongoing trials in the HR+/HER2- space… 1️⃣ HERTHENA-Breast04 (NCT07060807) 💊 Patritumab deruxtecan (HER3-DXd) vs physician’s choice chemo 💉 ADC of HER3 mAb linked to topoisomerase I payload 👆Primary endpoints: PFS and OS

16/18 #TumorBoardTuesday 👩🏻‍🏫Mini Tweetorial 10🏫 DESTINY-Breast04 👩‍🦳 2L metastatic HER2- low BC ✅ Included both ER+ and ER-; HER2-low breakdown: IHC1+ = 58% and IHC2+ = 42% 💊 Trastuzumab deruxtecan (T-DXd) vs physician’s choice chemo (capecitabine, eribulin, gemcitabine, paclitaxel or nab-paclitaxel)

15/18 #TumorBoardTuesday ⏭️ Moving on to Case 3… #TumorBoardTuesday #OncTwitter Case 3 👩‍🦳 67 y.o. postmenopausal female 💉 Metastatic HR+, “HER2 low” BC to bone, liver 💊 Progressed on 1L CDK4/6i + ET within 4 months of starting therapy 🧪 No BRCA mutations

14/18 #TumorBoardTuesday 👩🏻‍🏫Mini Tweetorial 9🏫 📰 Breaking news! 🔊 evERA study (#ESMO2025) 🔎 Phase III, randomized trial (NCT05306340) 👩‍🦳 Metastatic HR+/HER2- ✅ Previous tx w/ CDK4/6i + ET 💊 Giredestrant is a novel, nonsteroidal oral SERD 🚫 NOT FDA approved as of today

13/18 #TumorBoardTuesday 👩🏻‍🏫Mini Tweetorial 8🏫 PrE0102: An oldie but goodie 👩‍🦳 2L mBC AI-resistant, HR+/HER2- ✅ Prior ET, < 1 chemo 💉 Fulvestrant + Everolimus (mTOR inh) vs Fulvestrant ⬆️ mPFS 10.3 months fulvestrant + everolimus vs 5.1 fulvestrant 👄 Mucositis → steroid mouth rinse (SWISH study ppx)

12/18 #TumorBoardTuesday 👩🏻‍🏫Mini Tweetorial 7🏫 EMBER-3 👩‍🦳 2L mHR+/HER2- 💊 Imlunestrant, next gen oral SERD with 🧠CNS activity ✅ 1-2 prior ET +/- CDK4/6i [recurrence < 12 mon or adj CDK4/6i/AI or PD on 1L CDK4/6i/ET] 📝 💊 Imlunestrant daily vs SOC [fulvestrant or exemestane] vs Imlunestrant + Abema

11/18 #TumorBoardTuesday 👩🏻‍🏫Mini Tweetorial 6🏫 EMERALD 👩‍🦳 2L mHR+/HER2- Elacestrant, po SERD ✅ 1-2 prior ET incl CDK4/6i, < 1 chemo 💊 Elacestrant daily vs 💉fulvestrant or AI ⬆️PFS for prior CDK4/6i >12 mon + ESR1mut ⬆️ PFS all subgroups incl 🦴only, 🫁 visceral, >3 mets

10/18 #TumorBoardTuesday 👩🏻‍🏫Mini Tweetorial 5🏫 🤔What is “endocrine resistant”? Per ABC Intern'l Guidelines, 👉 Recurred while taking adj ET 👉 Recurred < 2 yrs of adj ET 👉 Progressed < 6 mons of starting 1L mBC tx 👉 Progression after 2L+ ET 👉 Known ESR1 mut [use elacestrant or imlunestrant]

9/18 #TumorBoardTuesday ⏭️ Moving on to Case 2… #TumorBoardTuesday #OncTwitter Case 2 👩‍🦳 62 y.o. postmeno female 💉 mBC to the lungs, ER 70%, PR 85%, HER2 neg [IHC 1] with progression on 1L ribociclib/letrozole at C7. 🏃‍♀️ ECOG PS1. No co-morbidities. ⛔ Nml VS, labs 🩸Liquid Biopsy: ESR1mut, TMB-High

8/18 #TumorBoardTuesday Back to our case🔎 👩‍🦳 Received Capi + Fulvestrant [PIK3CA mutation]. 👉 Not yet endocrine resistant [not move to cape, saci] 👉 Tumor is HER2 neg [no TDxD] 👉 Not Everolimus + fulvestrant b/c more targeted approach PIK3CA ✅ Mild rash at start -> resolved with antihistamines

7/18 #TumorBoardTuesday 👩🏻‍🏫Mini Tweetorial 4🏫 💊Approved PIK3CA-inh: Capivasertib or Alpelisib or Inalvosalib 🤔 How do you PIK? ☝️Inavolisib + Fulvestrant + Palbo-> 1st line mER+ BC s/p recurrence on/after adj ET ✌️Both Alpelisib, Capi approved in 2nd line mER+ BC + fulvestrant 🔎 NGS, Baseline A1C

5/18 #TumorBoardTuesday Back to our case🔎 💉 57yo ♀️ mBC to the bones, liver, ER100%, PR95%, HER2 neg [IHC 0] with progression on 1L ribociclib/letrozole at C47 ✅ Normal labs (A1C = 5.8), VS 🩸Liquid Biopsy: +PIK3CA mut, TP53 mut, TMB-Low, tumor fraction (> 5%) 👩🏻‍⚕️ Recommend 2L therapy next…

4/18 #TumorBoardTuesday 👩🏻‍🏫Mini Tweetorial 3🏫 CAPItello-291: Capi Side effects 💊 Capi: 4 days on, 3 days off per week 🩺 Baseline A1C < 8% 🚽 Common AE: Diarrhea day 8 [All grades 72%, G3/4 9.3%] ☝️ Rash (12%) ~ day 12→ oral antihistamine, topical steroids 💉 Hyperglycemia (18%)~ day 15; ⬇️ G3/G4

3/18 #TumorBoardTuesday 👩🏻‍🏫Mini Tweetorial 2🏫 CAPItello291 👩‍🦳 mER+/HER2- BC, PD on AI+/-CDK4/6i 💉2L Fulvestrant +/- capi [🚫AKT plus 🚫PTEN, 🚫PIK3CA] ✅ Capi + fulvestrant ⬆️mPFS in AKT alterations [7.3m vs 3.1m] ✅ Capi+Fulvestrant benefited all incl 🦴only, 🫁 visceral mets, prior CDK4/6i, prior ☣️chemo

POLL What would you do next? A) Start capecitabine B) Liquid biopsy C) Start trastuzumab deruxtecan D) Check tumor markers Ca 15-3, Ca 27.29 @christianrolfo.bsky.social @quirogad.bsky.social @nerealliamd.bsky.social @stoverlab.bsky.social @drsgraff.bsky.social @oncbrothers.bsky.social

1/18 #TumorBoardTuesday #OncTwitter Case 1 👩‍🦳 57 y.o. postmenopausal female 📋 Well controlled diabetes (A1C = 5.8) 🏃‍♀️ ECOG PS 0 💉 Metastatic breast cancer to the bones, liver, ER100%, PR95%, HER2 neg [IHC 0] with scan confirmed progression on 1L ribociclib/letrozole Cyc 47 in bones. ⛔ Normal labs,VS

Tune in tomorrow 10/21/25 at 8pm EST for discussion about the ever changing landscape of 2L metastatic ER+ breast cancer #TBT #BCSM @tumorboardtuesday.bsky.social @osuwexmed.bsky.social #BreastCancer

🎙️Looking forward to a great #TBT discussion on Oct 21, 2025 on 2L ER+/HER2- #metastaticbreast cancer #BCSM @osuwexmed.bsky.social

Excited to share my #Top5 in #breastcancer from #ASCO25 #bcsm @osuwexmed.bsky.social www.vumedi.com/video/ascor-...

Last training ride before #pelotonia25. Since May, I’ve spent 30 hours and traveled more than 360 miles so that next Saturday I will ride 50 miles with more than 7,000 of my closest friends to help support #CancerResearch #onegoal #LetsDoThis #FuelMyRide ➡️ www.pelotonia.org/profile/MG0328

@oncoalert.bsky.social annual #ASCO25 5K on a beautiful morning in Chicago! Had some great running partners this am @quirogad.bsky.social @christeeny513.bsky.social

#ASCO25 has started! Great catching up with @drsgraff.bsky.social and Dr Gao!

Wonderful time giving grand rounds today at #Georgetown There’s nothing quite like going “home” to your alma mater and seeing all the amazing preceptors and mentors that so positively impacted your life #HoyaSaxa

Beautiful morning on campus with Buckeye grove in bloom @osuwexmed.bsky.social @osucccjames.bsky.social

Today family picture with some of the 87 amazing faculty of our Division of Medical Oncology at The James CCC. Very honored to be part and lead this incredible team! @OhioStateMedOnc @OSUCCC_James @OhioStateMed @drgattimays.bsky.social @stoverlab.bsky.social

Honored and grateful for the opportunity to discuss 3 oral abstracts at #ASCO25 and represent #OSUCCC @osucccjames.bsky.social @osuwexmed.bsky.social #Immunotherapy @sitcancer.bsky.social #PIIO @ascocancer.bsky.social

Passed this every day in Building 10 on the way to my office at the NIH. “…look to the service from the healthcare givers at the NIH. It is where knowledge, pride and love is given from each healthcare giver; To heal and comfort the sick and afflicted helping to give a brand new start”

Always fun to speak to graduate students about the importance of the work they do in the lab and show them how their work is translated 🧬🧫 -> 🛌 🩻 to benefit patients I see in clinic #Research #AcademicMedicine #Oncology @osuwexmed.bsky.social @osucccjames.bsky.social

Did you know? 99% of all new medications resulted from federally-funded university research through #NIH Learn more about #ResearchSavesLives: hub.jhu.edu/research-sav....

Patient education on #BreastCancer #Subtypes with #PatientPower @osuwexmed.bsky.social @osucccjames.bsky.social #bcsm www.patientpower.info/video/breast...

#THEOhioState is a great place to work #GoBucks #AcademicJobs

Bravo @stoverlab.bsky.social 👏👏

Deadline approaching! The #SITC Women in Cancer Immunotherapy Network Leadership Institute applications close March 24. Don’t miss your opportunity to participate in panel discussions and presentations from experienced female leaders. Learn more here: www.sitcancer.org/professional...

#Immunotherapy can induce cutaneous sarcoid #irAE @osucccjames.bsky.social @osuwexmed.bsky.social www.frontiersin.orgundefined/journals/imm...

New Journal for ImmunoTherapy of Cancer ( #JITC ) position article and guidelines: Society for Immunotherapy of Cancer (SITC) consensus statement on essential biomarkers for immunotherapy clinical protocols bit.ly/4hlPSMw

On International Women’s Day we honor the past, present, and future contributions of women who make our state stronger.

Looking for your first faculty position? Or perhaps new start? THE Ohio State University Comprehensive Cancer Center (Columbus, OH) is hiring in several #MedOnc sections - GI, Thoracic, Breast, Neuroendocrine, cutaneous. #AcademicJobs #OSUCCC @osucccjames.bsky.social @christianrolfo.bsky.social

Apply now for a one-year, $100,000 SITC Diversity, Equity and Inclusion Fellowship. Letter of Intent due on March 12. #SITCFellowship #ECR sitcancer.org/sitc2025

So excited for @sitcancer.bsky.social #ACI #WomensMalignancies that is about to start 11am EST

Some days I just really feel this #AcademicMedicine

Discuss real-world case studies with clinical experts! #SITC’s ACI: Women’s Malignancies program will explore practical insights to apply immunotherapy into clinical practice. Join Feb. 28 for a free CME program. Register now: ow.ly/bTFn50UYy9j @drgattimays.bsky.social @veredstearns.bsky.social

This 👇💪

Fly Eagles Fly!!! 🦅

In Ohio during FY23 (2022-2023) this was the impact of NIH funding: $1.01 Billion in grants and contracts $2.05 Billion in economic support 13,061 jobs supported This reduction in NIH indirect will decimate research and limit health care advances www.unitedformedicalresearch.org/nih-in-your-...

Great session with Dr Heather McArthur on treating early stage #TNBC #IO posted on #ReachMD @osuwexmed.bsky.social @osucccjames.bsky.social reachmd.com/programs/cme...

Happy to share our retrospective study on #pneumonitis risk in patients with #breastcancer who receive #TDXd #Enhertu @stoverlab.bsky.social @osucccjames.bsky.social #bcsm