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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