Updates on HR-positive HER2-negative breast cancer

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Published: 8 Jul 2023
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Dr Mariana Chavez - MD Anderson Cancer Center, Houston, USA

Dr Mariana Chavez speaks to ecancer about the updates from ASCO 2023 on HR-positive HER2-negative breast cancer. She reviews some important studies in the early-stage setting and some in the metastatic setting.

Dr Chavez discusses in detail the NATALEE, SONIA, PALMIRA and TROPICS-02 trials. 

She concludes by saying that the best of ASCO meetings are very important as they help in processing and reviewing a lot of the information that is presented at ASCO. 

What was your presentation today?

Today I had the opportunity to review some of the most important and relevant abstracts presented at ASCO related to breast cancer, the subtype of patients with hormonal receptor positive HER2 negative breast cancer. I reviewed some studies in the early stage setting and some in the metastatic setting.

In the early stage setting I had the opportunity to talk about the NATALEE trial, a very interesting study evaluating the addition of ribociclib in the adjuvant setting in our patients, and an update on the Oxford overview assessing the impact of ovarian suppression in the risk of recurrence and in the risk of mortality in patients according to their menopausal status before or after chemotherapy.

In the metastatic setting there were some very interesting studies presented at ASCO. The ones that I presented today at Best of ASCO included the SONIA study, a Dutch study that sequenced CDK inhibitors either in the first line or in the second line, trying to really answer the question of whether we can potentially delay the initiation of CDK inhibitors in some patients. I also discussed the PALMIRA study which is a small study that evaluated, tried to answer, the question of what’s the role of continuation of palbociclib after progression to CDK inhibitor in patients with metastatic disease who received treatment with palbociclib in the first line. Patients were then randomised to switch treatments, endocrine therapy, or switch treatment and continue CDK inhibitor. The study did not show any improvement in the continuation of CDK inhibitors.

Lastly I updated the audience on the results from the TROPICS-02 study. This is a study in patients with metastatic disease using sacituzumab govitecan, an antibody-drug conjugate, randomised to receive this drug versus treatment of physician’s choice. We heard updates in ASCO in terms of overall survival. So this drug has an improvement or impact on overall survival in our patients. So we talked about the results, the design and how all of this changes practice for us and how to implement that for the care of our patients.

What is the importance of having events such as BEST of ASCO?

The Best of ASCO meetings are very important. They help us digest a lot of the information that we see at the annual meeting, ASCO. It’s very large, there’s a lot of information for general oncologists that have to treat patients with different malignancies. Sometimes it’s impossible to attend all of the sessions. So it just helps us digest more, discuss from experts in the field one specific disease type, how to incorporate these new results into practice. In addition, it’s always, of course, a great opportunity for all of us to interact, learn from each other and continue interacting and discussing how to better treat our patients.