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Carlos Barrios

Carlos Barrios is the most visible Latin American voice in global breast cancer trials and a founder of the region's cooperative group LACOG.

Carlos Barrios has been a steering-committee member on numerous global breast cancer trials and co-founded the Latin American Cooperative Oncology Group, expanding trial access across the region; he collaborates with major São Paulo centres.

Role
Medical oncologist; Director, Oncology Research Center, Hospital São Lucas PUCRS; Latin American Cooperative Oncology Group
Specialisms
Breast cancerClinical trials in Latin AmericaGlobal oncology

Key papers

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rctNew England Journal of Medicine 2024changed practice
DESTINY-Breast06: trastuzumab deruxtecan before any chemotherapy in hormone-receptor-positive, HER2-low or ultralow breast cancer

Patients with hormone-receptor-positive metastatic breast cancer that has stopped responding to endocrine therapy can be offered trastuzumab deruxtecan as their first chemotherapy-type treatment if the tumour shows any HER2 staining, rather than waiting until after conventional chemotherapy. Whether to use it before or after chemotherapy is now a choice, since overall survival was not shown to differ and the drug carries a risk of lung inflammation.

rctNew England Journal of Medicine 2024changed practice
NATALEE: three years of ribociclib after surgery in a broad population of hormone-receptor-positive early breast cancer

Ribociclib is a second adjuvant CDK4/6 option, and the only one with data in node-negative stage II disease. Roughly 3 in 100 patients avoid a relapse or death at three years, so the decision depends heavily on individual risk, tolerance of a three-year oral drug, and cost. Whether the benefit persists after treatment ends, as it did with abemaciclib, needs longer follow-up.

rctJournal of Clinical Oncology 2024
TROPION-Breast01: datopotamab deruxtecan versus chemotherapy in pretreated hormone-receptor-positive breast cancer, and why a PFS win did not translate to survival

For hormone-receptor-positive metastatic breast cancer that has already had chemotherapy, Dato-DXd controls the disease for longer with fewer severe side effects than chemotherapy, but does not help patients live longer, so it is not a standard option here. The result is a reminder that progression-free survival is a surrogate; regulators and clinicians should wait for survival data before adopting an ADC in a setting where later therapies are effective.

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