SABCS recap: Predicting recurrence; pausing therapy for pregnancy; a ‘new gold standard’
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This year’s San Antonio Breast Cancer Symposium spotlighted practice-changing research in several subtypes.
Abstracts highlighted a potential new “gold standard” for certain patients with HER2-positive unresectable or metastatic breast cancer, as well as an effective combination for pre- or perimenopausal patients with hormone receptor-positive, HER2-negative disease.
Other studies showed longer duration of cyclin-dependent kinase 4/6 inhibitor therapy in the metastatic setting appeared associated with better outcomes after subsequent therapy, and that a genomic assay may identify which patients with hormone receptor-positive early disease may derive greater benefit from the addition of ovarian function suppression therapy to primary adjuvant endocrine therapy.
Healio presents the following 10 updates from SABCS that may be relevant to your practice.
1. Fam-trastuzumab deruxtecan-nxki (Enhertu; AstraZeneca, Daiichi Sankyo) significantly extended OS compared with ado-trastuzumab emtansine (Kadcyla, Genentech) among certain previously treated patients with HER2-positive unresectable or metastatic breast cancer. The findings suggest trastuzumab deruxtecan should be “the gold standard therapy” in this setting, researcher Sara A. Hurvitz, MD, FACP, told Healio. Read more.
2. First-line ribociclib (Kisqali, Novartis) plus endocrine therapy appeared associated with longer PFS and fewer adverse events than combination chemotherapy among pre- or perimenopausal patients with hormone receptor-positive, HER2-negative disease, even if they had visceral crises. Read more.
3. A genomic assay identified risk for distant recurrence among certain premenopausal women with hormone receptor-positive, early-stage breast cancer. The Breast Cancer Index assay (Hologic/Biotheranostics) also identified which of these patients may derive greater benefit from the addition of ovarian function suppression therapy to primary adjuvant endocrine therapy. Read more.
4. Levels of a prognostic biomarker for distant metastatic recurrence varied by race among a subset of women who received neoadjuvant chemotherapy. Read more.
5. Longer duration of cyclin-dependent kinase 4/6 inhibitor therapy in the metastatic setting appeared associated with extended PFS among patients treated with elacestrant (Menarini Group/Radius Health) for advanced breast cancer. The benefit appeared more pronounced among patients with ESR1 mutations. Read more.
6. Young women with early hormone receptor-positive breast cancer who temporarily stopped endocrine therapy to attempt pregnancy experienced similar short-term recurrence risk as those who did not stop. Read more.
7. Camizestrant (AstraZeneca) significantly prolonged PFS compared with fulvestrant among postmenopausal women with advanced ER-positive, HER2-negative breast cancer. Read more.
8. The addition of capivasertib (AZD5363, AstraZeneca) to fulvestrant significantly extended PFS among patients with hormone receptor-positive, HER2-negative breast cancer. Read more.
9. Fam-trastuzumab deruxtecan-nxki improved outcomes compared with capecitabine-based regimens as third-line treatment for certain patients with HER2-positive metastatic breast cancer. Results showed longer survival and higher response rates with fam-trastuzumab deruxtecan-nxki among patients previously treated with ado-trastuzumab emtansine. Read more.
10. The benefit of adding abemaciclib (Verzenio, Eli Lilly) to adjuvant endocrine therapy for certain patients with high-risk breast cancer deepened with time. A pre-planned interim analysis of the monarchE trial — which included patients with hormone receptor-positive, HER2-negative, node-positive, high-risk early breast cancer — showed increases in absolute improvement in invasive DFS and distant RFS benefit at 4 years compared with 2- and 3-year estimates. Read more.
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