As we begin 2026, Dr Ana Tecic Vuger (University Hospital for Tumors, Zagreb, Croatia) reflects on the major breakthroughs throughout 2025.
The breast cancer community has witnessed transformative progress across the continuum of research and clinical care, from more precise targeted therapies and novel endocrine strategies to advances in biomarker-driven treatment sequencing and survivorship. Major oncology meetings such ASCO 2025, ESMO/ESMO Breast 2025 and the San Antonio Breast Cancer Symposium (SABCS) 2025 offered a rich tapestry of data that helps shape practice and sharpen research priorities.
At ASCO 2025, several pivotal breast cancer studies underscored the value of precision-guided therapy and strategic sequencing.
- PIK3CA-targeted triple therapy breakthrough: The phase III INAVO120 trial demonstrated that adding inavolisib to palbociclib and fulvestrant significantly improved overall survival and nearly doubled time to chemotherapy in patients with PIK3CA-mutated ER+/HER2- advanced disease. This represents an important step forward beyond CDK4/6 inhibition alone, with potential to reshape first-line strategies.
- Novel endocrine modulators: New hormonal agents showed promise in endocrine-resistant disease. Vepdegestrant, an oral PROTAC SERD, improved progression-free survival in ESR1-mutant metastatic breast cancer compared with fulvestrant, while liquid biopsy-guided switches to camizestrant highlighted precision targeting of emerging resistance.
- Triple-negative breast cancer (TNBC) advances: Data from the ASCENT-04/KEYNOTE-D19 trial showed that sacituzumab govitecan + pembrolizumab outperformed traditional chemo-plus-immunotherapy regimens in metastatic, PD-L1-positive triple-negative breast cancer, setting the stage for new frontline options in this difficult-to-treat subtype.
These studies collectively demonstrate how molecular profiling and treatment adaptation, including biomarker-guided switches, are increasingly integral to advanced breast cancer care.
The ESMO and ESMO Breast 2025 meetings continued the momentum with several noteworthy developments.
- Expanded antibody drug conjugate (ADC) activity: New antibody-drug conjugates, including sacituzumab tirumotecan, showed superiority over physician’s choice chemotherapy in metastatic HR+/HER2- disease, reflecting broader applicability of ADCs beyond traditional targets.
- Targeted PI3K/AKT pathway agents: The PI3K/mTOR inhibitor gedatolisib improved progression-free survival when added to fulvestrant, with or without CDK4/6 blockade, offering another tool against endocrine-resistant disease.
- Pregnancy and therapy interruption: Long-term follow-up in the POSITIVE trial confirmed that pausing hormonal therapy for pregnancy does not increase recurrence risk, reassuring younger patients contemplating childbearing.
- Oral SERDs and combination endocrine strategies: Continued exploration of agents like giredestrant in combination with everolimus adds nuance to managing ESR1-mutant and resistant disease.
ESMO 2025 reinforced the evolution of breast cancer care toward more nuanced, subtype-specific treatment, with a growing emphasis on quality of life and survivorship, not just tumor response.
At the San Antonio Breast Cancer Symposium, early-stage disease and prevention took centre stage.
- Next-generation endocrine therapy: The phase III lidERA study showed that giredestrant significantly improved invasive disease-free survival over standard endocrine therapy in medium- to high-risk ER+/HER2- early breast cancer, which is a promising advance in adjuvant treatment.
- HER2-positive optimization: Tucatinib in combination with trastuzumab and pertuzumab extended frontline maintenance, reinforcing the value of multiple HER2-targeted agents in early and metastatic settings.
SABCS continued to highlight the importance of optimizing curative-intent therapy and integrating novel agents earlier in the disease course.
Additionally, SABCS featured emerging AI and multi-omic technologies poised to refine risk assessment, tumor characterization, and treatment personalization, foreshadowing future translational leaps.
2025 was a landmark year in breast cancer research and practice. It showcased deeper understanding of molecular subtypes, the continued emergence of ADC and endocrine strategies, and more precise, biologically driven therapy selection. We saw progress not only in survival outcomes but also in patient-centered decision-making, whether through treatment breaks for pregnancy, personalized switches guided by liquid biopsy, or quality-of-life-oriented supportive care.
As we look toward 2026 and beyond, I believe the following themes will shape the next wave of progress.
- Integration of AI and multi-omic profiling into routine clinical pathways for screening, risk stratification and therapeutic choice.
- Enhanced combination immunotherapy strategies, particularly in subtypes like TNBC where immunogenicity and resistance mechanisms remain key challenges.
- Continued emphasis on de-escalation or personalization of therapy intensity, matching treatment burden to biologic risk.
- Expanded focus on survivorship, late effects and equity in access to cutting-edge care.
The breast cancer landscape continues to evolve rapidly, but as always, each incremental advance brings us closer to more effective, more tolerable and more personalized care for patients around the world.
Disclosure: Ana Tecic Vuger has nothing to disclose in relation to this interview. This short article was prepared by touchONCOLOGY in collaboration with Dr Ana Tecic Vuger. Views expressed are the author’s own and do not necessarily reflect the views of Touch Medical Media.
Editor: Sophie Nickelson (Editorial Director).
Cite: Breast cancer 2025: A year in review. touchONCOLOGY. February 3rd, 2026
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