Highlights in Metastatic Breast Cancer From ASCO 2021

Lisa A. Carey, MD


June 28, 2021

Dr Lisa Carey, a breast cancer specialist from the University of North Carolina at Chapel Hill, looks at the latest data in metastatic breast cancer presented at the 2021 American Society of Clinical Oncology Annual Meeting.

First, Dr Carey reviews an updated analysis from the PALOMA-3 trial of the CDK4/6 inhibitor palbociclib plus fulvestrant in women with HR+/HER2- advanced disease. This report showed that the observed survival benefit with the combination is maintained out to 6 years.

Next, she describes another updated survival analysis, this time from the MONALEESA-3 trial, which assessed fulvestrant plus another CDK4/6 inhibitor, ribociclib, in postmenopausal women with HR+/HER2- advanced disease. Again, the combination was associated with a survival benefit of almost 5 years, as well as a delay in subsequent chemotherapy.

Dr Carey then reviews the Chinese sysucc-002 trial of endocrine therapy or chemotherapy added to trastuzumab in HR+/HER2+ disease. With noninferior outcomes and lower toxicity, trastuzumab plus endocrine therapy could become the preferred option and allow women to avoid chemotherapy.

She next turns to a subanalysis of the ASCENT trial, which examined sacituzumab govitecan in previously treated triple-negative disease. Even in the second-line metastatic setting, the drug showed a survival benefit.

Dr Carey concludes by discussing a study that gathered patients’ views on treatment-related adverse effects, finding that over 90% would be willing to discuss alternative dosing options to improve their quality of life.


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