SABCS 2020: A Physician's Guide to Anticipated Advancements in Breast Cancer Care

Announcer:
Welcome to Breaking Boundaries in Breast Cancer on ReachMD, sponsored by Lilly. Ahead of the 2020 San Antonio Breast Cancer Symposium, we caught up with Dr. William J. Gradishar,  Professor of Medicine at the Robert H. Lurie Comprehensive Cancer Center at Northwestern University, who shared with us some of the updates in breast cancer that he’s most excited to learn about at the conference.

Let’s hear from Dr. Gradishar now.

Dr. Gradishar:
At this year’s San Antonio Breast Cancer Symposium, there are a number of studies that I think are going to be important, and some are updates of data we’ve already seen, and others are brand new data that has not been presented.  There are a number of different trials as well as molecular assay trials trying to define the role of using these assays to determine whether or not the addition of chemotherapy makes sense even in patients with low-burden node-positive disease.  We’re going to have the spectrum of clinical data from actual antitumor efficacy in advanced disease as well as benefits in the adjuvant setting, and then, of course, looking at quality-of-life, patient-related outcome data, so it will be an exciting year.

As an example of updates, we heard at ESMO  just a few months ago that the use of CD4/6 inhibitors in the adjuvant setting had sort of a mixed bag of results.  In one trial there was clearly a benefit, the monarchE trial with abemaciclib, whereas in another trial with palbociclib, the results were negative, so this year at San Antonio we’ll hear the updated results from the monarchE trial with respect to invasive disease-free survival.  And we’ll also hear another trial, the PENELOPE-B trial, which is in a somewhat different setting.  It’s the use of palbociclib for patients at high risk of recurrence because they have residual disease at surgery following neoadjuvant chemotherapy.

And again, at ESMO we heard the results of the ASCENT trial, which was an evaluation of sacituzumab govitecan, an antibody drug conjugate for triple-negative breast cancer, and the patients weren’t selected based on any particular biomarker, although sacituzumab govitecan is largely targeting TROP-2.  And this biomarker study is really going to look at the ASCENT data set and try to determine whether there’s any specific target that sacituzumab govitecan works better in. 

There are other trials that are going to be presented looking at targeted agents,  including a double-blind trial, the IPATunity130 study, which looks at the role of ipatasertib combined with paclitaxel for patients with PI3 kinase AKT/PTEN-altered, locally advanced or metastatic triple-negative breast cancer.

And then, if there’s brand new data with new drugs, such as, the chemotherapy drug tesetaxel, or even the use of targeted agents, such as those drugs targeting the PI3 kinase AKT pathway in metastatic triple-negative breast cancer, will those drugs result in an impactful enough outcome improvement that we see rapid approval by the FDA? 

So that’s sort of a tease because most of us have not seen the data, but we’re going to have to pay attention to it because it could very well have an effect and impact on the patients we take care of.

Announcer:
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