Comment on new treatment options for breast cancer

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Published: 20 Oct 2018
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Prof Nadia Harbeck - Klinikum der Universität München, Munich, Germany

Prof Nadia Harbeck speaks at the ESMO 2018 congress in Munich about data presented by Prof Peter Schmid, Prof Fabrice Andre and Prof Massimo Cristofanilli.

For more on the findings of IMpassion130, using atezolizumab and nab-paclitaxel to treat mTNBC, watch Prof Schmid present the results here.

For more from the PALOMA-3 study, including OS data from palbociclib with fulvestrant in HR /HER2- advanced breast cancer, watch Prof Cristofanilli speak here.

For more from the SOLAR-1 trial of alpelisib for advanced breast cancer, watch Prof André discuss the results here.

The first abstract presented by Professor Schmid targeted triple negative breast cancer which is a breast cancer, once it’s metastatic, with a dismal prognosis. We have a lot of patients out there right now in clinical trials with immune therapy but so far in breast cancer we have not seen the tremendous effects that we’ve seen in melanoma or lung cancer. So this is the first time we have a phase III trial proving that immune therapy in triple negative breast cancer improves survival. This is something that will change the way we practise in triple negative breast cancer.

The other two studies they targeted hormone receptor positive HER2 negative breast cancer, even though Professor André said with a poor prognosis it’s much better than the triple negative breast cancers but we haven’t seen much progress there. We’ve seen the CDK4/6 inhibitors and there are three compounds from three different companies and they all prolong progression free survival but there is still a lot of uncertainty out there in the community whether to give these drugs, when to give these drugs and also from the payer’s perspective because there’s no overall survival. So this is now going to change; 10 months overall survival benefit in a CDK4/6 inhibitor study in this second line setting is unprecedented and will change people’s hearts who weren’t quite sure. I think we can now confidently say to our patients that this is the drug to take, and my personal opinion also, in the first line setting. Please keep in mind for this particular presentation I’m a bit biased because I’m a co-author.

And Fabrice’s talk, and Giuseppe said this very nicely, is going to lead us into the area of precision medicine. Also here we’ve had numerous talks, also phase III trials with a PI3 kinase inhibitor where we saw marginal benefit and the drugs were unusable in clinical practice because the tolerability was so bad. So this is now the first phase III data proving that if you have a targeted drug and the tumour has the target you can actually almost double progression free survival. This will also change the way we practise in hormone receptor positive breast cancer because we now have to define the targets and then treat accordingly.

All of these abstracts are extraordinary and we’ll be very privileged to hear them this afternoon at four o’clock. Thank you very much.