Highlights on breast cancer 1
Presented by Dr Elisa Agostinetto (Institut Jules Bordet, Brussels)
Dr Elisa Agostinetto, a medical oncologist and research fellow at Institut Jules Bordet in Brussels, Belgium, provides a comprehensive overview of five selected abstracts presented at ASCO 2024 during the rapid oral abstract session on local, regional, and adjuvant breast cancer.
The first abstract examined the pathological complete response of the datopotamab deruxtecan cohort within the I-SPY 2.2 trial. This adaptive trial, conducted in the neoadjuvant setting for early breast cancer, showcased the potential of datopotamab deruxtecan monotherapy, an antibody-drug conjugate combining the anti-TROP2 monoclonal antibody datopotamab and the cytotoxic payload deruxtecan. While approximately 30% of patients proceeded to surgery after four cycles, avoiding traditional chemotherapy, the results did not meet the pre-specified threshold for advancing to a phase three trial.
The second abstract analysed a subanalysis of the FLEX trial, investigating the association between the MammaPrint index and clinical outcomes in patients with hormone receptor-positive, HER2-negative early breast cancer treated with chemotherapy, with or without anthracycline. The study revealed that patients with a high MammaPrint index may benefit from anthracycline, underscoring the predictive value of MammaPrint in determining anthracycline benefit.
The third abstract delved into a sub-analysis of the NATALEE trial, focusing on patients with node-negative tumours. This analysis confirmed the consistent benefit of adding ribociclib in the adjuvant setting for high-risk, hormone receptor-positive, or negative early breast cancer, including those with node-negative disease.
The fourth abstract addressed the benefit of adjuvant endocrine therapy in patients with estrogen receptor-low (ER-low) tumours. While omitting adjuvant endocrine therapy was associated with worse overall survival in over 10,000 ER-low tumours, caution was urged due to study design limitations and the heterogeneous nature of ER-low tumours.
The final abstract explored a sub-analysis of the GEICAM/2003-11_CIBOMA/2004-01 study, focusing on identifying patients with early triple-negative breast cancer who benefit from adjuvant capecitabine. By investigating the immunohistochemistry expression of FOXC1, the study provided valuable insights into refining treatment strategies for this patient population.
Overall, Dr Agostinetto’s synopsis offers a comprehensive glimpse into the latest advancements and critical inquiries in the field of local, regional, and adjuvant breast cancer therapy.
