Dr. Drago and Dr. Traina continue their discussion of breakthrough developments in triple-negative breast cancer treatment, sharing highlights from the promising ASCENT-04 trial results with sacituzumab govitecan plus pembrolizumab in first-line treatment. They also address key clinical challenges around sequencing antibody-drug conjugates and managing interstitial lung disease toxicity.

The ACIP voted to replace universal newborn hepatitis B vaccination with shared clinical decision-making for infants of mothers who test negative, a move strongly criticized by major medical and public health groups who warn it could reverse decades of progress in preventing pediatric hepatitis B. A large NEJM trial found that a single dose of HPV vaccine provides protection equivalent to two doses over five years, supporting simplified global vaccination strategies. Real-world evidence from nearly 5,000 patients shows dapagliflozin and empagliflozin deliver similar safety and effectiveness across all forms of heart failure.

Dr. Tiffany Traina and Dr. Josh Drago discuss the evolving treatment landscape for HER2-low and ultralow breast cancer, highlighting how pivotal trials like Destiny Breast-04 and Destiny Breast-06 have demonstrated significant efficacy improvements with trastuzumab deruxtecan while emphasizing the need to balance its toxicity profile with benefits for individual patients.

Drs. Danilov and Coombs review the evolving treatment strategies for CLL, focusing on the use of CAR T-cell therapy and allogeneic stem cell transplant in different disease stages, particularly for patients with relapsed or refractory disease. They emphasize the importance of tailoring treatment to individual patient needs, considering clinical trials, and recognizing challenges.

Drs. Danilov and Coombs explore the potential benefits and challenges of CAR T-cell therapy in CLL, emphasizing the importance of personalized treatment decisions and shared decision-making between physicians and patients.

A large population study links trimethoprim-sulfamethoxazole to a rare yet nearly threefold higher risk of severe acute respiratory failure in healthy adolescents and young adults, reinforcing FDA warnings and the need for careful monitoring. Two extensive Cochrane reviews—including over 132 million people—confirm that HPV vaccination dramatically reduces cervical cancer, high-grade precancers, and anogenital warts without increasing serious adverse events. Kentucky's deadly pertussis surge highlights declining vaccine coverage and the critical role of maternal Tdap and timely childhood immunization to protect the most vulnerable infants.

Drs. Camacho and Lewiecki discuss emerging osteoporosis therapies that are revolutionizing bone health treatment, with promising developments like oral parathyroid hormone medications and dual-action anabolic agents that challenge traditional injection-based approaches. Biosimilars, particularly for denosumab, are expanding patient access by offering highly similar, potentially more affordable alternatives to brand-name drugs, signaling a transformative era in osteoporosis care.

Drs. Lewiecki and Camacho discuss sequential therapy in osteoporosis as a critical strategy that involves strategically switching between anabolic and antiresorptive treatments to maximize bone mineral density and reduce fracture risk. By carefully transitioning between different drug classes (eg, romosozumab; teriparatide; denosumab), clinicians can optimize patient outcomes and address the evolving needs of individuals with bone health challenges.

A long-term Framingham Heart Study analysis shows that regular physical activity beginning in midlife and continuing into older age significantly lowers the risk of dementia, including Alzheimer disease, with the most active individuals experiencing roughly 40–45% risk reduction. A phase 3 trial of the first oral PCSK9 inhibitor, enlicitide, demonstrated substantial LDL-C and apoB reductions in patients with heterozygous familial hypercholesterolemia already on statins, offering a well-tolerated oral option that helps most patients reach guideline targets. Finally, a large U.S. cohort study revealed persistent under-treatment of chronic hepatitis B—especially among women and non-Asian racial groups—highlighting the need for standardized assessment and timely antiviral therapy to close these gaps.

Drs. Camacho and Lewiecki discuss trabecular bone score (TBS) as a groundbreaking approach to assessing fracture risk by evaluating bone quality beyond traditional bone density measurements. By integrating TBS with FRAX® and showing promise across diverse patient populations, this innovative technique helps clinicians identify patients at risk of fractures who might otherwise be overlooked by standard diagnostic methods.