Conference MDAngle: SABCS 2024 Hormone Receptor (HR)–Positive, HER2-Negative Breast Cancer

Conference MDAngle offers personal perspectives from conference attendees, showcasing their anticipation, quick takeaways, and insights into how the presented research will affect their patients.

The 2024 San Antonio Breast Cancer Symposium (SABCS) was held on December 10-13. The meeting featured a range of events on the latest developments in breast cancer research and several significant presentations focused on hormone receptor (HR)–positive, human epidermal growth factor receptor 2 (HER2)–negative breast cancer. This included findings from the PADMA study, comparing endocrine therapy plus CDK4/6 inhibitors vs chemotherapy as a first-line treatment in high-risk metastatic cases, and the EMBER-3 trial, evaluating an oral selective estrogen receptor degrader (SERD) to improve patient outcomes. In addition, DESTINY-Breast06 examined HER2-low–directed therapies after one or more lines of endocrine-based therapy. These sessions underscore the emphasis at SABCS 2024 on advancing precision in therapeutic strategies for HR+/HER2- breast cancers, contributing to more targeted and effective treatments.

Avan J. Armaghani, MD

Assistant Member, Department of Breast Oncology, Moffitt Cancer Center, Tampa, Florida

"We know that with the standard run-of-the-mill chemotherapy, we don’t get that robust response, pathologic complete response that we see with patients with triple-negative breast cancer or our patients with HER2-positive breast cancer. So, trying to identify other novel therapies and strategies for this population of patients, for the patients with hormone receptor–positive breast cancer, I think will be very interesting."

Norah L. Henry, MD

Professor, Department of Internal Medicine, University of Michigan Medical School; Physician, Rogel Cancer Center, Ann Arbor, Michigan

"There is the promise of a considerable amount of new, clinically applicable data across the board, including both systemic and local therapies for treatment of invasive and noninvasive breast cancer, biomarker analyses, and prevention of breast cancer."

Preconference Considerations

SABCS 2024: Previewing New Data in HR+/HER2- Breast Cancer

Dr Armaghani highlights exciting research in HR+/HER2- breast cancer to be presented at SABCS 2024. This includes a phase 2 trial on HER3-directed therapies in early-stage cases, the EMBER-3 trial on imlunestrant in metastatic settings, and the PADMA study comparing endocrine therapy with chemotherapy in high-risk patients. From a lifestyle and wellness standpoint, she is also interested in the BWEL trial's weight loss intervention for patients with breast cancer.

Quick Clinical Takeaways

SABCS 2024: Key Highlights in HR+/HER2- Breast Cancer

Back from the San Antonio Breast Cancer Symposium, Dr Henry notes how the PADMA trial showed that combining endocrine therapy with palbociclib significantly improved treatment outcomes for patients with high-risk metastatic estrogen receptor–positive (ER+)/HER2-negative breast cancer. The EMBER-3 trial demonstrated that the oral SERD imlunestrant, especially when combined with abemaciclib, improved progression-free survival compared to standard therapies. Additionally, the DESTINY-Breast06 trial found that trastuzumab deruxtecan improved progression-free survival over chemotherapy in ER+/HER2-low metastatic breast cancer, providing valuable insights into treatment strategies for these patients.

How Will My Patients Benefit?

SABCS 2024: Clinical Impact of Advances in HR+ Breast Cancer

Dr Henry shares key clinical takeaways from two studies presented at this year’s San Antonio Breast Cancer Symposium. The PADMA trial demonstrated that combining endocrine therapy with palbociclib significantly improved progression-free survival compared with chemotherapy in patients with high-risk metastatic hormone receptor–positive, HER2-negative breast cancer. Additionally, an exploratory analysis of the TAILORx trial showed a 5% improvement in distant recurrence–free survival with anthracycline-based chemotherapy in patients with high 21-gene recurrence scores, offering critical insights for tailoring chemotherapy decisions.

Polling Question

Summary

The 2024 San Antonio Breast Cancer Symposium showcased significant advancements in hormone receptor-positive, HER2-negative breast cancer research, including findings from the PADMA study, which demonstrated improved outcomes with endocrine therapy and CDK4/6 inhibitors compared to chemotherapy for high-risk metastatic cases. The EMBER-3 trial introduced the oral SERD imlunestrant, showing promising progression-free survival, particularly in combination with abemaciclib, while the DESTINY-Breast06 trial highlighted the efficacy of trastuzumab deruxtecan in HER2-low metastatic breast cancer. Additional highlights included a phase 2 HER3-DXd antibody-drug conjugate study for high-risk early breast cancer. Drs Armaghani and Henry emphasized the importance of these findings in advancing precision medicine and optimizing treatment strategies for breast cancer patients.

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