Dr. Kalinsky on Therapeutic Options Beyond Chemotherapy in High-Risk Breast Cancer

Kevin Kalinsky, MD, MS, director of the Glenn Family Breast Center and Breast Medical Oncology at Winship Cancer Institute, and an associate professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine, discusses treatment options beyond chemotherapy in patients with high-risk breast cancer.

One of the questions that remains in the phase 3 RxPONDER trial (NCT01272037) is whether the chemotherapy benefit is due to the ovarian function suppression effect, or whether there is a direct effect, as well, Kalinsky says. A limitation of the study was that at 6 months after randomization, only approximately 16% of patients had received ovarian function suppression, which is an optimal endocrine therapy, Kalinsky notes.

Another question from the RxPONDER study, as well as the phase 3 TAILORx trial (NCT00310180), is whether patients who have a recurrence score that is greater than 25 would benefit from options beyond chemotherapy, Kalinsky continues. To date, mixed data have been reported with CDK4/6 inhibitors in the adjuvant setting, Kalinsky notes.Additionally, questions remain regarding the benefit of treatment beyond chemotherapy in a genomically high-risk population, Kalinsky adds.

For those with higher-risk disease, an unmet need remains with regard to new approaches, such as novel antiestrogen therapies, combinations, or other targeted therapies that patients could receive in addition to hormonal therapy, Kalinsky concludes.