Breast Cancer

The European Commission has approved elacestrant for the treatment of postmenopausal women and men with estrogen receptor–positive, HER2-negative, locally advanced, or metastatic breast cancer with an activating ESR1 mutation who have disease progression following at least 1 line of endocrine therapy including a CDK4/6 inhibitor.

Stephanie L. Graff, MD, discusses the advantages of interrupting endocrine therapy in premenopausal patients with endocrine-responsive breast cancer who are seeking to conceive, based on findings from the phase 3 POSITIVE trial.

Key opinion leaders review the use of antibody-drug conjugates (ADCs) in treating HR+/HER2- metastatic breast cancer, and how they counsel patients before starting them on therapy with an ADC.

Over the past 10 years, data from studies including the TAILORx and RxPONDER studies have reshaped treatment standards for patients with hormone receptor–positive, HER2-negative breast cancer.

Experts discuss the complexity of defining endocrine resistance in patients with HR+/HER2- metastatic breast cancer and the options for treatment.

The panel explains how treatment experience with CDK4/6 inhibitors varies for patients with HR+/HER- breast cancer, and which agents are best tolerated.

Dr Naomi Dempsey explains how she decides on an appropriate CDK4/6 inhibitor for patients receiving first-line treatment for metastatic HR+/HER- breast cancer.

Malinda West, MD, MS, discusses the use of adjuvant endocrine therapy in combination with CDK4/6 inhibitors in the treatment of patients with early-stage HER2-negative breast cancer.

Stephanie L. Graff, MD, expands on treatment options available for patients with premenopausal breast cancer who are trying to conceive, highlighting the POSITIVE trial in women with endocrine-responsive breast cancer.

Sneha Phadke, DO, MPH, discusses the benefit associated with treatment consisting of the antibody drug conjugates sacituzumab govitecan in hormone receptor-positive/HER2-negative breast cancer.

Marina Sharifi, MD, PhD, discusses the benefit of utilizing personalized and targeted therapy approaches in the treatment of patients with breast cancer.

Naomi Dempsey, MD, reviews data on the use of CDK4/6 inhibitors for the frontline treatment of metastatic HR+/HER- breast cancer.

Nadia Nocera Zachariah, MD, explains why early detection and monitoring of lymphedema is crucial in patients with HR+/HER- breast cancer, with technologies like prophylactic compression sleeves and nighttime compression systems showing promise in reducing negative impact on quality of life.

Sneha Phadke, DO, MPH, discusses sequencing treatment with antibody drug conjugates in hormone receptor-positive/HER2-negative breast cancer, as well as questions remaining within this space.

Virginia Kaklamani, MD, presents the case of a 47-year-old premenopausal woman diagnosed with HR+/HER2- metastatic breast cancer for discussion.

Virginia Kaklamani, MD, and Elizabeth Diaz, PA-C, offer an overview of HR+/HER2- metastatic breast cancer and detail the standard-of-care first-line therapy options.

Erika P. Hamilton, MD, discusses the benefit seen with adjuvant ribociclib in patients with hormone receptor-positive,HER2-negative breast cancer.

Dr Naomi Dempsey shares the study design, primary outcome data, and the 3-year invasive disease-free survival follow-up data from the NATALEE trial in HR+/HER2- breast cancer presented at ASCO 2023.

Experts explain the challenges patients with HR+/HER- breast cancer face in accessing abemaciclib for treatment and the options available such as patient assistance programs for high co-pays.

Avan Armaghani,cdiscusses the feasibility of de-escalating treatment in triple-negative breast cancer, as well as planned or ongoing research investigating this approach in the neoadjuvant and metastatic settings.

Raymond Mailhot Vega, MD, MPH, delves into the rationale for exploring the outcomes of patients who underwent axillary surgery or sentinel lymph node biopsy, explained the implications of these findings, and detailed what eventual data from the phase 3 Alliance A011202 could mean for the breast cancer treatment paradigm.

Dionisia Quiroga, DO, PhD, discusses the emergence of the HER2-low categorization in breast cancer as well as current treatment options for patients with HER2-low disease.

Meghana Kesireddy, MBBS, discusses the pending FDA approval of the AKT inhibitor capivasertib plus the selective estrogen receptor degrader fulvestrant in patients with hormone receptor–positive, HER2-negative breast cancer.

Margaret E. Gatti-Mays, MD, MPH, FACP, discusses updated biomarker data from the phase 2 NeoPACT trial of neoadjuvant chemoimmunotherapy in triple-negative breast cancer.

The panel discusses the importance of careful chemotherapy dosing and management of side effects for patients with HR+/HER- breast cancer, including the use of cooling and compression gloves to prevent peripheral neuropathy.

Naomi Dempsey, MD, presents the clinical scenario of a 60-year-old woman with newly diagnosed HR+/HER- breast cancer to the panel for discussion.

The FDA and Eagle Pharmaceuticals have agreed on the next steps for the development of EA-114, an estrogen receptor antagonist and novel formulation of fulvestrant used in the treatment of postmenopausal women with breast cancer.

Sara M. Tolaney, MD, MPH, highlights updated survival and safety data seen with sacituzumab govitecan in patients with hormone receptor–positive, HER2-negative breast cancer; underscores how Trop-2 and HER2 testing is not necessarily needed for this agent in this population at this time; and shares how ongoing efforts are exploring the utilization of this agent earlier in the treatment course.

Andrew McKenzie, PhD, discusses the updates to the ASCO clinical practice guidelines for biomarker testing in patients with metastatic breast cancer.

Bhuvaneswari Ramaswamy, MD, discusses the importance of real-world data when considering the efficacy of the CDK 4/6 inhibitor palbociclib in hormone receptor–positive breast cancer.