SABCS 2025 Unveils Breakthroughs in Breast Cancer Treatment

The San Antonio Breast Cancer Symposium (SABCS) 2025, held from December 9 to 12 in San Antonio, Texas, showcased significant advancements in breast cancer therapies. Clinicians, researchers, and oncology pharmacists convened to discuss emerging data that could reshape treatment approaches for various breast cancer subtypes. Key highlights included innovations in targeted therapies, refinements in treatment sequencing, and enhanced roles for pharmacists in precision oncology.

Updates from the MONALEESA trials underscored the long-term efficacy of ribociclib (Kisqali; Novartis), a CDK4/6 inhibitor used in hormone receptor-positive (HR+), HER2-negative advanced breast cancer. The latest results revealed sustained progression-free survival benefits and manageable safety profiles, reinforcing ribociclib’s critical position in standard endocrine therapy. These findings reaffirm the role of CDK4/6 inhibitors as foundational treatments for HR+ metastatic breast cancer, providing clinicians with confidence in long-term patient outcomes.

Shifting Standards of Care with New Therapies

Emerging analyses from the DESTINY-Breast trial portfolio highlighted the potential for trastuzumab deruxtecan (T-DXd, Enhertu; Daiichi Sankyo) to redefine standards of care. This therapy showed promise across various patient populations, including those with HER2-positive and HER2-low breast cancer. Presentations at SABCS emphasized improvements in systemic control and patient outcomes, showcasing the expanded impact of antibody-drug conjugates (ADCs) in treating breast cancer with diverse HER2 expression levels.

Another significant revelation came from the HER2CLIMB-05 trial. This study evaluated the addition of tucatinib (Tukysa; Array BioPharma) to maintenance therapy with trastuzumab (Herceptin; Genentech) and pertuzumab (Perjeta; Genentech) following initial treatment in metastatic HER2-positive breast cancer. The results indicated an impressive median progression-free survival (PFS) increase of 8.6 months, extending the duration without disease progression from approximately 18 months to nearly 25 months. This improvement not only enhances disease control but also allows patients to defer cytotoxic chemotherapy, thereby improving their quality of life.

Innovations in CNS Management and Supportive Care

A central theme at SABCS 2025 was the growing role of ADCs in treating HER2-positive breast cancer, particularly among patients with central nervous system (CNS) involvement. Traditionally, the blood-brain barrier has limited treatment options for brain metastases, which affect nearly 50% of patients with advanced HER2-positive disease. ADCs like T-DXd and sacituzumab govitecan (SG; Trodelvy, Gilead Sciences) demonstrated significant intracranial activity, with DESTINY-Breast12 data reporting response rates around 50% and promising PFS in patients with brain metastases.

Amid these discussions on novel therapies, the symposium also addressed practical considerations in supportive care. The use of GLP-1 agonists in oncology settings was highlighted, with an emphasis on monitoring for gastrointestinal side effects, making appropriate dose adjustments, and fostering interdisciplinary coordination. These measures aim to mitigate adverse events while promoting overall patient well-being during cancer therapy.

The role of pharmacists in precision oncology also emerged as a recurring theme at SABCS. With the increasing complexity of targeted agents, pharmacists are uniquely positioned to enhance therapeutic outcomes. Their responsibilities include interpreting genomic profiles, managing drug interactions, and educating patients on new regimens, solidifying their integral place within multidisciplinary cancer care teams.

Collectively, the data presented at SABCS 2025 reflect a growing movement towards individualized treatment pathways. Clinicians and oncology pharmacists face both challenges and opportunities in integrating these emerging findings into practice. The focus remains on selecting appropriate patients for innovative regimens, balancing efficacy with safety, and ensuring that supportive care evolves alongside therapeutic advancements.