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2. #PADMA: Ph III, HR+ metastatic breast cancer, chemo vs ET + Palbociclib.

- #SABCS22 in #RightChoice study, we knew CDK4/6i upfront is better.

- Time to treatment failure and PFS better in PADMA. CDK4/6i remain 1L SoC for these pts

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Want to get #SABCS22 updates from some of the best breast oncologists on the planet? For free! DM me for the link to the Bay Area Great Cancer Forum featuring Drs. @hoperugo, Michelle Melisko, and Jo Chien. TONIGHT (Wed 1/25) at 6 PM PACIFIC

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.@SABCSSanAntonio how can those of us who were at #SABCS22 in person watch sessions we missed because cloning isn’t a thing yet?

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After 3.5 weeks 🤿 🐠 in Cozumel and another 5 days at #SABCS22, I’m glad to be home with my boys, even if it is 🌨 ❄️ 💨. Going to light a 🔥, make some homemade 🍲 and find a good 📖 to read.
Tomorrow it’ll be snow shoveling and DoD grant critique writing.

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Saw so many wonderful folks at #SABCS22 but 😢 I didn’t get to talk to @DrSGraff - we have to make a date for #SABCS23 if not sooner

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😞 to be leaving #sabcs22 in hopes of beating a major ❄️ storm at home. Seeing #advocate, oncologist, & researcher friends recharged me. This is the ⭐️ breast cancer conference & while the science is incredible, I really come for the people 💙💚💗 🏨 for #sabcs23 already booked!

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Dr @AngieDemichele on RCT vs RWE - and immediately comments it really should be RCT and RWE; randomized trials plus real world evidence is an example of #StrongerTogether #sabcs22 #bcsm

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There are alternatives to a MTD approach. CDK4/6 inhibitors are as effective at lower doses - but do people who tolerate the higher dose NEED the higher dose for efficacy?? With alpelisib lower doses don’t work as well as higher doses. #sabcs22 #bcsm

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Why study a dose if people can’t tolerate it and drop out of the trial or over 50% need a dose reduction. #sabcs22 #bcsm

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And it’s not the only drug where MTD/recommended starting dose got thrown out PDQ. #sabcs22 #bcsm

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Capecitabine (Xeloda) is a good example of a drug where no one uses MTD, which is the recommended starting dose, because it’s intolerable #sabcs22 #bcsm

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Maximum tolerated dose (MTD) is kinda whatever doesn’t kill you makes you better 🤷‍♀️ #sabcs22 #bcsm

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So Dr @hoperugo how come YOU don’t have slides on RIP MTD in the app 😂#sabcs22 #bcsm

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Always love and learn so much from these @abreastcancer sessions with the @FDAOncology breast team Drs @tmprowell @pre_ryan Bindu Libyan and Asma Dilawari #sabcs22 #bcsm

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One thing not up for debate: a CDK 4/6 inhibitor (specifically ribociclib) + endocrine therapy is better than chemo in first line aggressive disease. #sabcs22 #bcsm

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Dr Ruth O’Regan takes the “nope, they’re different” side, structurally and in side effects, but also in OS #SABCS22 #bcsm

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Dr Pratt: “we’re really lucky to have all 3 agents”. This can allow matching the right drug to the right patient.
#SABCS22 #bcsm

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There are differences in OS but there are limitations in the palbo trials in that a high % of people dropped out when palbo was approved in 2015 (and therefore could get without being on a trial). RWE has shown palbo does have an OS benefit (no slide available) #sabcs22 #bcsm

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Dr Debra Pratt, taking the “yes, all CDK 4/6 inhibitors are the same” is having technical difficulties with updated slides 😝 so for now I’ll just share what’s in the app. Original trials all showed very similar PFS but side effects are different #sabcs22 #bcsm

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Now up: debate on whether all CDK4/6 inhibitors are the same #sabcs22 #bcsm

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.@SABCSSanAntonionext year can you PLEASE make sure 1 exhibitor has that yummy Mexican hot chocolate?? #sabcs22

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No slides for this talk about PROTAC ARV471 😢 and I’m too far back in the room to get good projected slide 📸. Will find and retweet others’ take on this trial. #sabcs22

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Will have to tweet additional slides from this general session later - seems like the app is overloaded as everything froze! #sabcs22 #bcsm

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An oral pill rather than a 💉 in the 🍑 every month would be a welcome option but there are GI side effects 🤢, although very few people stopped therapy due to side effects. #sabcs22 #bcsm

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Promising data on elacestrant from the EMERLAD trial. Elacestrant is an oral SERD. Everyone has been on a CDK 4/6 inhibitor and it worked well in people with an ESR1 mutation #sabcs22 #bcsm

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#advocates, including @faceofstage, bring up an excellent point in a poster discussion session: our TREATMENTS often cause weight gain, which impacts our outcomes. Instead of blaming people for weight gain maybe we should be blaming treatments #sabcs22 #bcsm

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I’d call this the Goldilocks effect: those underweight and those overweight at breast cancer diagnosis had higher mortality than those whose weight was just right. #sabcs22 #bcsm

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Not MBC, but an interesting study on breast density. BD ⬇️ with ⬆️ age and ⬆️ weight. In a breast that ultimately develops cancer, density ⬇️ slower than in the other breast in which cancer didn’t develop. Seems like we need a density score that can be followed. #sabcs22 #bcsm

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Trilled to meet @arielcarmeli who walked the walk on involving #advocates in his research, even including me and @jamilkali as co-authors on the #sabcs22 poster and future manuscripts. @MBC_Project #BCSM

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Like everything else, resistance to ADCs can and will develop. Fortunately smart people are studying this and sequential, staggered use might be a solution. #sabcs22 #bcsm

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