SABCS

Patients with hormone receptor (HR)-positive, HER2-negative advanced breast cancer, including those with visceral crises, treated with the CDK4/6 inhibitor ribociclib (Kisqali) plus endocrine therapy had a significantly longer progression-free survival (PFS) and fewer adverse events (AEs) compared with those treated with combination chemotherapy, according to results from the phase 2 RIGHT Choice trial.
Using circulating tumor cell (CTC) count to guide the choice of first-line treatment—chemotherapy or endocrine therapy—improved overall survival (OS) compared with investigator’s choice of treatment for patients with metastatic, estrogen receptor (ER)-positive, HER2-negative breast cancer, according to results from the STIC CTC trial, which were discussed at the 2022 San Antonio Breast Cancer Symposium (SABCS) by François-Clément Bidard, MD, PhD, Co-Coordinator, Breast Cancer Research, Institut Curie, Paris, France, and Professor, Medicine, Department of Medical Oncology, Institut Curie and Université de Versailles Saint-Quentin-en-Yvelines, France.
In patients with hormone receptor (HR)-positive, HER2-low or -negative, locally advanced or metastatic breast cancer resistant to aromatase inhibitors, the addition of the investigational first-in-class AKT inhibitor capivasertib (AZD5363) to fulvestrant (Faslodex) led to a statistically significant and clinically meaningful improvement in progression-free survival (PFS) compared with placebo plus fulvestrant.
Final results from the pivotal phase 3 KEYNOTE-355 trial showed that the addition of pembrolizumab (Keytruda) to chemotherapy resulted in a statistically significant and clinically meaningful improvement in overall survival (OS) compared with chemotherapy alone in patients with metastatic triple-negative breast cancer (TNBC) whose tumors expressed PD-L1 with a combined positive score (CPS) ≥10.
Second-line therapy with trastuzumab deruxtecan (Enhertu; T-DXd) extended progression-free survival (PFS) and improved objective response rate (ORR) versus trastuzumab emtansine (Kadcyla; T-DM1) in women with HER2-positive metastatic breast cancer, including those with stable brain metastasis at baseline, according to a subgroup analysis of a phase 3 clinical trial.
Dr Matthew Goetz addresses common questions that arise when patients with HER+ metastatic breast cancer have progressed on a CDK4/6 inhibitor plus an aromatase inhibitor.
Dr Matthew Goetz believes that, as more mature data come into existence, the demonstration of a survival advantage will guide more patients with metastatic breast cancer to try CDK4/6 inhibitors plus aromatase inhibitors instead of chemotherapy.
Dr Matthew Goetz explains the rationale for using CDK4/6 inhibitors in patients with HR-positive metastatic breast cancer.
The new oral selective estrogen receptor degrader (SERD) elacestrant demonstrates potent antitumor activity in in vitro models, with additive effects to CDK4/6 inhibitors.
CDK6 may be a useful biomarker in patients with estrogen receptor–positive breast cancer who develop acquired resistance to CDK4/6 inhibitors, and inhibition of the PI3K/Akt/mTOR pathway may be a reasonable therapeutic approach for these patients.
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