Please start the new year with our congress report of the 2022 San Antonio Breast Cancer Symposium.
Here are some key points:
Checkpoint inhibitors are relevant in the neo-adjuvant treatment of early triple-negative breast cancer. Whether targeting both PD-L1 and Lag-3 (a new target) is superior to single targeting remains to be seen.
Trastuzumab deruxtecan outperforms other current second-line treatments for metastatic, Her2-positive breast cancer and may represent an option in the neo-adjuvant setting.
Combining endocrine treatment with a CDK4-antagonist is not only less toxic than combination chemotherapy – it actually provides superior disease recurrence-free survival.
Genomic analysis may not only prevent overtreating patients with early breast cancer in terms of chemotherapy, but they may also give hints on the duration of adjuvant endocrine treatment. Other assessments may identify patients benefitting from the addition of checkpoint inhibition to neo-adjuvant treatments. A pre-therapeutic circulating tumour cell count might (further?) identify patients requiring adjuvant chemotherapy.
What to do after the failure of initial CDK4-antagonist/endocrine first-line treatment in metastatic HR-positive breast cancer? Some studies give answers.
Did you consider de-escalation in the adjuvant treatment of ductal carcinoma in situ? Maybe you will after reading about the TAM-01 study.
I’m sure you’ll find some practice-changing features in our report.
Yours, sincerely
Stefan Rauh
Biography
Dr Stefan Rauh is currently working as haematooncologist in the oncology department of the Centre Hospitalier Emile Mayrisch, Esch, Luxembourg. He is mainly involved in clinical work but also in research and teaching activities and is interested in public policy and international cooperation projects in oncology. He is member of the ESMO Practicing Oncologist’s Working Group since 2011 (chair 2014-2018) and the ESMO Public Policy Committee, and has been an ESMO Executive Board member in 2015-2016. He is co-author of the 2017 ESMO European Cancer Patient Coalition (ECPC) Patient Survivorship Guide and an invited expert for the ECPC.
Conflict of Interest Statement: Nothing to declare.
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Table of Contents: SABCS 2022
Featured articles
Miscellaneous
Racial disparity in the tumour microenvironment
Chemo-endocrine therapy worse for cognition than endocrine therapy alone
Early-Stage Breast Cancer
Anti-PD-1/anti-LAG-3 combination highly effective in HER2-negative breast cancer
MammaPrint test predictive for benefit of extended endocrine therapy
HR-positive/HER2-positive Breast Cancer: Trastuzumab-Deruxtecan
Trastuzumab deruxtecan effective in both second-line and neoadjuvant setting
HR-positive/HER2-negative Advanced Metastatic Breast Cancer
Benefit of adjuvant abemaciclib continues to deepen at longer follow-up
First-line ribociclib plus endocrine therapy outperforms combination chemotherapy
Treatment options beyond CDK4/6 inhibition
Triple-Negative Breast Cancer
Baseline CTC count can guide first-line treatment in HR-positive/HER-negative metastatic breast cancer
ZNF689 deficiency promotes intratumour heterogeneity and resistance to immune checkpoint blockade in TNBC
Oestradiol represses anti-tumoural immune response to promote progression of brain metastases
Basic and Translational Research
Resistance to CDK4/6 inhibitors is likely due to expansion of pre-existing resistant clones
Germline pathogenic variants for breast cancer also increase contralateral breast cancer risk
Low-dose tamoxifen still prevents recurrence from non-invasive breast cancer
Endocrine interruption to pursue pregnancy does not impact short-term disease in breast cancer
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