ESMO 2025: Highlights in breast cancer

Summary The ESMO Congress 2025 highlighted major advances in breast cancer, with numerous clinically relevant abstracts, some of which were immediately practice-changing. In hormone receptor-positive/HER2-negative breast cancer, adjuvant abemaciclib has now demonstrated an overall survival benefit in the monarchE study, while the 5‑year update from the NATALEE trial showed a sustained benefit with adjuvant ribociclib. These findings suggest a durable carryover effect of CDK4/6 inhibition beyond the treatment period in the adjuvant treatment of hormone receptor-positive/HER2-negative breast cancer. In HER2-positive breast cancer, trastuzumab deruxtecan is emerging as a treatment option in both adjuvant and neoadjuvant settings, based on data from the DESTINY-Breast05 and DESTINY-Breast11 trials. In metastatic triple-negative breast cancer, both sacituzumab govitecan and datopotamab deruxtecan have demonstrated superiority over conventional chemotherapy, and antibody–drug conjugates are now considered the standard of care in the first-line setting.