Researchers at the San Antonio Breast Cancer Symposium, held in December, reported promising news about several advances in treatment. The antibody-drug conjugate Enhertu (trastuzumab deruxtecan) continues to shine. Two studies showed that the drug improves overall survival for women with previously treated HER2-positive metastatic breast cancer, while a third study showed that neoadjuvant, or presurgery, treatment for people with HER2-low breast cancer yielded good response rates.
For HER2-negative breast cancer, researchers reported that adding capivasertib, an experimental AKT inhibitor, to the hormone therapy fulvestrant (Faslodex) more than doubled progression-free survival for patients with advanced disease. The RIGHT Choice study suggested that the CDK4/6 inhibitor Kisqali (ribociclib) plus hormone therapy may be a more effective and better tolerated initial treatment option for young women with aggressive HER2-negative metastatic breast cancer.
Turning to earlier breast cancer, some women with two or three tumors in the same breast—who are traditionally advised to undergo a mastectomy—had good outcomes with breast-conserving lumpectomy followed by radiation. The recurrence rate was 3%, similar to the rate for women with only a single tumor. Another study found that genetic profiling could identify patients who may be able to safely skip radiation after breast-conserving surgery. The gene profile, dubbed POLAR, may “help mitigate toxicities and improve quality of life for many patients,” says Per Karlsson, MD, of the University of Gothenburg in Sweden.
Finally, results from the POSITIVE study showed that women with breast cancer who paused hormone therapy to get pregnant had recurrence rates similar to those of women who did not pause treatment, and many went on to deliver healthy babies.