Recent updates from SABCS 2025 highlight significant progress in the treatment of metastatic triple-negative breast cancer (TNBC), particularly with the growing role of antibody–drug conjugates (ADCs). In this discussion, Drs. Reshma Mahtani, Heather McArthur, and Anne O’Dea review the ASCENT-04 / KEYNOTE-D19 trial, which demonstrated improved progression-free survival with sacituzumab govitecan plus pembrolizumab compared with standard chemotherapy plus pembrolizumab in PD-L1–positive metastatic TNBC. The panel notes that these findings have already influenced practice, with the NCCN guidelines updated in January 2026 to include sacituzumab govitecan plus pembrolizumab as a Category 1 preferred first-line option for PD-L1–positive disease. They also discuss considerations for immunotherapy rechallenge after prior pembrolizumab exposure and preview ongoing studies such as TROPION-Breast05, which may further clarify the role of ADCs and immunotherapy combinations in the first-line setting. Sponsored By Gilead.