Conference MDAngle: ASCO 2024 Metastatic 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 American Society of Clinical Oncology (ASCO) Annual Meeting was held in Chicago, Illinois, from May 31 to June 4. Sessions covered a wide range of topics relevant to metastatic breast cancer, including new data on the application of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, the expanding use of antibody-drug conjugates, increasing racial and ethnic diversity in clinical trials, and improving response rates and progression-free survival in patients with hormone receptor-positive, human epidermal growth factor receptor (HER2)-low, and HER2-ultralow metastatic breast cancer.

Kevin M. Kalinsky, MD

Division Director, Winship Cancer Institute, Atlanta, Georgia

"For ASCO 2024, the main takeaways are that continuing a CDK4/6 inhibitor and switching the endocrine therapy in a biomarker-unselected approach is an option, a strategy for patients. And for those patients with endocrine-resistant disease, where you really need to get a response, there are data now supporting giving trastuzumab deruxtecan earlier for your patients who have low disease, as well as some data supporting [giving trastuzumab deruxtecan for] ultralow."

Preconference Considerations

ASCO 2024: Anticipating Advancements in Metastatic Breast Cancer

At ASCO 2024, Dr Kalinsky anticipates that the session on metastatic breast cancer will provide significant findings regarding HER2-negative breast cancer, notably focusing on CDK4/6 inhibitors following prior treatment. The postMONARCH study will offer insights into abemaciclib's efficacy alongside fulvestrant post-CDK4/6 inhibitor progression, and updates from trials like TROPION-Breast01 and INAVO120 will shed light on antibody-drug conjugates and PI3K inhibitors in endocrine-resistant disease. In addition, presentations will delve into the efficacy of antibody-drug conjugates alone and with immunotherapy in HER2-negative breast cancer, alongside discussions on the role of CDK4/6 inhibitors in HER2-positive breast cancer.

Quick Clinical Takeaways

ASCO 2024: Two Key Highlights in Metastatic Breast Cancer Care

Dr Kalinsky shares insights on two clinically impactful studies. DESTINY-Breast06 demonstrated the efficacy of trastuzumab deruxtecan in HER2-low metastatic breast cancer post-endocrine therapy progression. In addition, the postMONARCH trial showed the benefits of switching to abemaciclib with fulvestrant after initial CDK4/6 inhibition, offering promising strategies for managing hormone receptor-positive disease.

How Will My Patients Benefit?

ASCO 2024: Impact of New Data on Treatment Strategies for Metastatic Breast Cancer

Dr Kalinsky reflects on data presented at ASCO 2024, noting how the DESTINY-Breast06 study revealed trastuzumab deruxtecan's efficacy in improving progression-free survival for patients with hormone receptor–positive, HER2-low breast cancer, suggesting its potential as an early treatment option. The postMONARCH study demonstrated improved progression-free survival with fulvestrant plus abemaciclib as a second-line treatment for hormone receptor–positive breast cancer, irrespective of biomarker status, accentuating it as a viable strategy for patients with endocrine-resistant disease.

Polling Question:

Summary

Among the advancements in metastatic breast cancer care presented at ASCO 2024, the postMONARCH study demonstrated the efficacy of switching to abemaciclib with fulvestrant post–CDK4/6 inhibitor treatment, offering a promising strategy for managing hormone receptor–positive disease. Additionally, the DESTINY-Breast06 trial demonstrated trastuzumab deruxtecan's effectiveness in HER2-low metastatic breast cancer post–endocrine therapy progression, indicating its potential for earlier use in treatment. These findings underscore the importance of personalized treatment approaches and offer hope for improved outcomes in breast cancer management.

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