Oct 28, 2019

Breast Cancer Update, Issue 3, 2019 — Part 2: Our interview with Dr Kaklamani highlights the following topics as well as cases from her practice:

• Efficacy and safety of the novel SERD elacestrant for ER-positive breast cancer; Phase III EMERALD trial evaluating elacestrant versus endocrine therapy (00:00)
• Incidence of ESR1 mutations; activity of elacestrant after disease progression on fulvestrant and a CDK4/6 inhibitor (02:14)
• Results from the Phase II ANETT trial of the mTORC1/2 inhibitor TAK-228 with tamoxifen as neoadjuvant therapy for ER-positive breast cancer (03:53)
• Novel approaches under investigation in the neoadjuvant setting (07:20)
• Perspective on the use of neoadjuvant therapy to optimize surgical outcomes for patients with ER-positive, HER2-negative breast cancer (09:43)
• Activity of CDK4/6 inhibitors for locally advanced ER-positive breast cancer (11:30)
• Case: A woman in her late 60s with ER-positive, HER2-negative breast cancer and 1 of 3 positive axillary lymph nodes receives a 21-gene assay RS of 18 (13:49)
• Role of the 21-gene expression assay in predicting chemotherapy benefit for patients with ER-positive breast cancer (15:56)
• Clinical and genomic risk to guide the use of adjuvant therapy for breast cancer (19:11)
• Case: A premenopausal woman in her late 40s with ER-positive, HER2-negative, node-negative breast cancer receives a RS of 19 (23:19)
• Clinical implications of the TAILORx trial comparing chemoendocrine therapy to endocrine therapy for patients with ER-positive, node-negative breast cancer and an intermediate RS (25:00)
• Tailoring adjuvant endocrine therapy for premenopausal women with ER-positive breast cancer (27:54)
• Benefit of endocrine therapy with or without chemotherapy for patients with ER-positive breast cancer and an intermediate RS; consideration of clinical and genomic risk in assessing the likelihood of disease recurrence (30:54)
• Case: A woman in her early 40s with ER-positive, HER2-negative breast cancer and metastases in the liver and bones attains a partial response to ribociclib in combination with endocrine therapy (35:24)
• Benefit with CDK4/6 inhibitors versus chemotherapy for ER-positive breast cancer with visceral metastases (37:57)
• Efficacy of ribociclib in premenopausal women; QT prolongation associated with ribociclib/tamoxifen (40:54)
• Comparison of the efficacy and toxicity profiles of abemaciclib, palbociclib and ribociclib for women with ER-positive mBC (42:24)
• Activity of CDK4/6 inhibitors as monotherapy; CNS penetration of CDK4/6 inhibitors (45:47)
• Monitoring and management of side effects associated with CDK4/6 inhibitors (48:07)
• Case: A woman in her mid-50s initially diagnosed with Stage II ER-positive breast cancer develops metastatic disease to the bone 8 years later and receives palbociclib and anastrozole (50:54)
• Perspective on the use of multiplex genomic assays to guide treatment decision-making for patients with ER-positive mBC (53:35)
• Results of the Phase III SOLAR-1 trial evaluating alpelisib for patients with ER-positive advanced breast cancer (55:54)
• Tolerability of alpelisib for patients with ER-positive breast cancer (57:54)
• Sequencing everolimus and alpelisib after disease progression on a CDK4/6 inhibitor (1:00:06)
• Case: A postmenopausal woman in her mid-30s with ER-positive mBC and BRCA2 and PIK3CA mutations receives talazoparib in the third-line setting (1:01:46)
• Choice of PARP inhibitor for patients with advanced breast cancer and BRCA mutations (1:04:58)
• Response and side-effect profiles of alpelisib (1:06:10)
• Selection and sequencing of therapy for patients with mBC and germline BRCA mutations (1:07:00)

CME information and select publications