First-Line Treatment for Metastatic TNBC: Inside the ASCENT-03 Trial | Dr. Alissa Huston, University of Rochester

<p>This episode is sponsored by Gilead Sciences. Gilead had no involvement or input in the podcast content. Gilead is working to transform how cancer is treated. We are innovating with next-generation therapies, combinations, and technologies to deliver improved outcomes for people with cancer. From antibody drug conjugates and small molecules to cell therapy-based approaches, our portfolio and pipeline assets are creating new possibilities for people with cancer.</p><p><br></p><p><strong>UPDATE SINCE RECORDING JANUARY 2026.</strong> Since this recorded conversation, the FDA has acted on the data discussed in this episode. On May 22, 2026, Datopotamab Deruxtecan was approved for first-line metastatic TNBC in patients who are not candidates for immunotherapy. On June 24, 2026, Sacituzumab Govitecan was approved for first-line use both as a single agent and in combination with pembrolizumab for PD-L1-positive disease (CPS ≥10). Consult with your care team for the most recent indications and availability of these treatment options.</p><p><br></p><p><strong>Metastatic triple-negative breast cancer has historically had the fewest targeted options of any breast cancer subtype. The ASCENT-03 trial changed the first-line picture.</strong></p><p><br></p><p>ASCENT-03 (NCT05382299) was a phase 3, open-label, randomized trial of 558 patients with unresectable locally advanced or metastatic triple-negative breast cancer who had not received prior systemic therapy for advanced disease and who were not candidates for PD-1 or PD-L1 inhibitor therapy. Participants were randomized 1:1 to sacituzumab govitecan-hziy or to physician&#39;s choice of chemotherapy (nab-paclitaxel, paclitaxel, or gemcitabine plus carboplatin).</p><p><br></p><p>0:00 Treating cancer like a game of chess </p><p>0:44 Introducing Dr. Alissa Huston </p><p>1:11 Breast oncology and integrative oncology in one practice </p><p>2:58 Twenty years of change: from tumor size to molecular profiling </p><p>4:28 Where metastatic triple-negative breast cancer stands today </p><p>5:55 What is PD-L1, and how does immunotherapy work? </p><p>6:46 Why immune-related side effects behave differently </p><p>8:05 Choosing between immunotherapy, ADCs, and chemotherapy </p><p>9:58 Inside ASCENT-03: what the trial studied and who it enrolled</p><p>12:15 Progression-free survival, explained in plain language </p><p>16:50 What the first appointment actually looks like</p><p>19:22 Holding hope and toxicity in the same conversatio