Community Oncology Connections: Navigating PD-L1–Driven Decisions and ADC Integration in Frontline mTNBC

Activity Overview

PD-L1 expression defines which patients with metastatic triple-negative breast cancer (mTNBC) are candidates for first-line pembrolizumab. However, only about 4 of 10 patients meet the combined positive score threshold of 10, and expression can differ between a primary tumor and a metastatic site. For the rest, the first-line standard has moved from chemotherapy toward antibody-drug conjugates (ADCs): sacituzumab govitecan and datopotamab deruxtecan were both approved in 2026 for patients who are not candidates for PD-1/PD-L1 inhibitors, and sacituzumab govitecan plus pembrolizumab for PD-L1–positive disease. Both agents carry distinct toxicities that demand different monitoring, and the neutropenia-related deaths in ASCENT-03 occurred in patients without growth factor prophylaxis. As community oncologists navigate this landscape, accurate PD-L1 and germline BRCA1/2 testing, regimen selection by PD-L1 status and immunotherapy eligibility, and proactive toxicity management have become critical.

This Community Practice Connection™ program provides an in-depth review of PD-L1 testing and first-line treatment selection in mTNBC. This unique and engaging multimedia activity is ideal for the community-based clinician. It focuses on practical interpretation of clinical trial data and management strategies for PD-L1 and germline BRCA1/2 testing, first-line regimen selection by PD-L1 status and immunotherapy eligibility, and ADC toxicity in the community oncology setting.

Target Audience

This educational program is primarily directed toward community-based oncologists, nurses, nurse practitioners, advanced practice providers, and other health care professionals involved in the treatment of TNBC. The online enduring activity also extends to an international audience of oncology clinicians, with open-access availability via http://gotoper.com to practitioners outside the United States.

Learning Objectives

Upon successful completion of this activity, you should be better prepared to:

• Describe how PD-L1 testing impacts treatment planning and regimen selection in patients with newly diagnosed, metastatic, triple-negative breast cancer (mTNBC)
• Select appropriate frontline strategies for mTNBC based on PD-L1 status, immunotherapy eligibility, patient preferences, and evolving clinical evidence
• Apply practical approaches to toxicity management, patient communication, and workflow integration in community oncology settings

The staff of Physicians’ Education Resource^®, LLC have no relevant financial relationships with ineligible companies.

PER^® mitigated all conflicts of interest for faculty, staff, and planners before the start of this activity by using a multistep process.

Off-Label Disclosure and Disclaimer

This accredited continuing education activity was planned in accordance with the ACCME Standards for Integrity and Independence to ensure balance, objectivity, independence, and scientific rigor. Faculty were instructed to use generic names when possible and to base recommendations on the best available evidence. Proprietary product names may be referenced in clinical discussion for educational purposes only and do not imply endorsement.

This activity may include discussion of investigational, unapproved, or off‑label uses of drugs or devices. Learners are advised to consult prescribing information for products discussed. Content is provided for educational purposes only and is not a substitute for the independent clinical judgment of a health care professional. Learners are encouraged to critically evaluate the information presented and apply their own clinical judgment.

The views expressed are those of the individual faculty members and do not necessarily reflect the views of the accredited provider or any entity providing commercial support.

This activity may have used AI-assisted tools to support educational development. All content was reviewed and approved by qualified faculty or planners. The accredited provider retains full responsibility for accuracy, balance, and independence.