What are your top takeaways in Breast Cancer from ASCO 2024?
Answer from: Medical Oncologist at Academic Institution
1. DESTINY-Breast06
This phase 3 trial randomized patients to either Trastuzumab deruxtecan (T-DXd) vs. physician’s choice chemotherapy (capecitabine, nab-paclitaxel, paclitaxel) in hormone receptor positive HER2 low or HER2 ultralow (any membrane staining) metastatic breast cancer after prio...
Answer from: Radiation Oncologist at Academic Institution
Fertility among young breast cancer survivors attempting pregnancy: A prospective, multicentre cohort study - Women with stage 0-III BC in the Young Women's Breast Cancer Study (YWS, NCT01468246), a multicenter, prospective cohort of women diagnosed at age ≤ 40 from 2006-2016 who reported attem...
Answer from: Medical Oncologist at Academic Institution
DB06 - T-DxD has benefit in ultralow HER2 as first line chemo-like option.
postMONARCH - abemaciclib has benefit after CDK46i progression
A-BRAVE - adjuvant avelumab may have benefit in TNBC
AMH in RxPONDER - benefit may be limited to those patients not in ovarian failure, suggesting that chemo...
Answer from: Medical Oncologist at Academic Institution
Abemaciclib plus fulvestrant vs fulvestrant alone for HR+, HER2- advanced breast cancer following progression on a prior CDK4/6 inhibitor plus endocrine therapy: Primary outcome of the phase 3 postMONARCH trial. This is the first phase 3 randomized trial that demonstrated that the CDK4/6 inhibitor...
Answer from: Medical Oncologist at Community Practice
DESTINY-Breast06: Two big shifts here in this trial for T-DXd, 1) 1st line cytotoxic for HR+ breast instead of 2nd line, and 2) included “ultra-low” HER-2 expression, aka IHC 0 that have some membrane expression. This will include another 20-25% of HR+ patients, so now about 85 or 90% ...
Answer from: Medical Oncologist at Academic Institution
Here are my top 3 takeaways from ASCO for breast cancer!
postMONARCH - First phase III study of fulvestrant with or without abemaciclib in patients who progressed on prior CDK 4/6 inhibitor and endocrine therapy that showed a statistically significant improvement in progression free survival with...
Comments
Medical Oncologist at Hematology Oncology Medical Group of Orange County AMH levels reported in commercial labs are in ng/m...
Answer from: Medical Oncologist at Academic Institution
Here are my thoughts:
DESTINY-Breast06 late-breaking presentation: While I don’t think it would result in us moving all HER2 low metastatic breast cancer patients to TDXd immediately after exhausting endocrine therapy, this data does give us more flexibility to use TDXd for patients who we ...
Answer from: Medical Oncologist at Community Practice
Definitely DESTINY-Breast06. This potentially changes our approach for ER+, HER-2 low, and ultra-low breast cancer moving Tdxt ahead of chemo in our usual treatment algorithm.
It also expands the population of patients potentially eligible for this treatment.
It also raises challenges of defining ...
Answer from: Medical Oncologist at Academic Institution
Abstract 513 by Choong et al. suggests that ET should still be given to patients with ER-low tumors. There has been a trend to omit ET in these patients. Undoubtedly, the benefit is smaller than in tumors with high ER expression.
Abstract 505 by Kalinsky et al. demonstrated the impact of ovarian ...
Answer from: Medical Oncologist at Academic Institution
While not immediately practice-changing; a series of abstracts drew attention to a subset of ER+ breast cancers that could benefit from immunotherapy, in the stage II-III setting.
In the June 3rd oral presentations session, the presentation by Dr. @Erin Cobain, “Elucidating the Immune Ac...
Answer from: Medical Oncologist at Academic Institution
There is an ultralow category that appears to identify patients who benefit from T-DXd. When DB-06 is approved by the FDA, the categorization of HER2 will change again to HER2 3+, negative. For everything else, the question of whether we need to differentiate between ultralow and low categories re...