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A Look Ahead to SABCS 2021

Joyce O'Shaughnessy, MD

Celebrating Women Chair in Breast Cancer Research
Breast Cancer Research Program
Baylor University Medical Center
Texas Oncology
US Oncology Network
Dallas, Texas

Joyce O’Shaughnessy, MD, has disclosed that she has received consulting fees from AbbVie, Agendia, Amgen, Aptitude, AstraZeneca, Bristol-Myers Squibb, Celgene, Eisai, G1 Therapeutics, Genentech, Immunomedics, Ipsen, Jounce, Lilly, Merck, Myriad, Novartis, Ondonate, Pfizer, Puma, Prime, Roche, Seattle Genetics, and Syndax.

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Sara Tolaney, MD, MPH

Associate Professor of Medicine
Division of Breast Oncology
Harvard Medical School
Chief, Division of Breast Oncology
Breast Oncology Program
Dana-Farber Cancer Institute
Boston, Massachusetts

Sara Tolaney, MD, MPH, has disclosed that she has received funds for research support (paid to her institution) from AstraZeneca, Bristol-Myers Squibb, Cyclacel, Eisai, Exelixis, Genentech, Immunomedics/Gilead, Lilly, Merck, NanoString, Nektar, Novartis, Odonate, Pfizer, Sanofi, and Seattle Genetics and has received consulting fees from 4D Pharma, AstraZeneca, Athenex, Bristol-Myers Squibb, Celldex, Certara, Chugai, CytomX, Daiichi Sankyo, Eisai, Ellipses Pharma, G1 Therapeutics, Genentech, Immunomedics/Gilead, Kyowa Kirin, Lilly, Mersana, NanoString, Nektar, Novartis, Odonate, OncoPep, OncoSec, Pfizer, Puma, Sanofi, Samsung Bioepsis, Seattle Genetics, and Silverback Therapeutics.

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Released: December 6, 2021

At the 2021 San Antonio Breast Cancer Symposium (SABCS), important results from many clinical trials on breast cancer will be reported. Here, renowned experts have highlighted some of their most anticipated abstracts, which will be covered online as a part of CCO’s independent Conference Coverage of SABCS 2021. After the meeting, remember to check the CCO website for a downloadable highlights slideset summarizing the data from these studies and a CME-certified online expert analysis activity featuring expert commentaries on the clinical implications of the data.

Top Picks
In the setting of early breast cancer, updated results from the phase III KEYNOTE-522 trial of neoadjuvant pembrolizumab plus chemotherapy for early-stage triple-negative breast cancer (TNBC) will be presented (GS1-01). This trial previously demonstrated that adding pembrolizumab to chemotherapy for high-risk, early-stage TNBC improved pathologic complete response and event-free survival. This presentation on key subgroup analyses may provide a better understanding of which patients with early-stage TNBC derive the greatest benefit from pembrolizumab. These additional data are likely to increase the use of preoperative pembrolizumab in lower-risk patients.

Several studies to be presented at SABCS 2021 in the metastatic breast cancer setting are likely to impact patient care. One of the most anticipated studies is the phase III EMERALD trial of elacestrant (GS2-02), an oral selective estrogen receptor degrader (SERD). This study compares oral elacestrant with endocrine monotherapy in patients with metastatic hormone receptor (HR)‒positive breast cancer who had progressed on previous therapy with a CDK4/6 inhibitor. This is expected to be a practice-changing study leading to the first approval of an oral SERD. If approved, this will be the first new endocrine therapy since fulvestrant was approved almost 20 years ago.

The MONALEESA series of trials has found survival benefits for ribociclib plus endocrine therapy for patients with metastatic HR-positive/HER2-negative breast cancer in various settings. Recently, the MONALEESA-2 trial reported a median overall survival with ribociclib plus letrozole of more than 5 years compared with a little more than 4 years with hormone therapy alone as first-line therapy in postmenopausal women. Further analysis of overall survival by metastatic site from a prespecified exploratory subgroup analysis will be presented (GS2-01). Also being presented will be an analysis from the MONALEESA-2, -3, and -7 trials on overall survival by intrinsic subtype (GS2-00). Together these data are anticipated to provide additional support for ribociclib as a preferred CDK4/6 inhibitor in the first-line setting, as well as refine the patient population most likely to benefit from therapy.

There is still a great need for additional therapies for patients with TNBC. One promising therapy is the novel antibody–drug conjugate datopotamab deruxtecan, which targets TROP-2. Preliminary evidence from the multitumor phase I TROPION-PanTumor01 study showed efficacy in TNBC. At SABCS 2021, updated efficacy and safety data will be presented for a TNBC expansion cohort (GS1-05). Also in TNBC, the final outcomes from the phase III KEYNOTE-355 study (GS1-02) of pembrolizumab plus chemotherapy in the first-line setting will be presented.

Additional Studies of Potential Interest
CCO’s independent Conference Coverage of SABCS 2021 will include coverage of additional studies, including:

  • P1-17-11: updated data from a phase I/II study of amcenestrant, an oral SERD, plus palbociclib in estrogen receptor–positive/HER2-negative breast cancer
  • PD4-04 and PD4-02: data on tucatinib plus trastuzumab and capecitabine for patients with HER2-positive breast cancer and brain or leptomeningeal metastases

Remember to Check Back!
Please visit the CCO website after the meeting to get more information about these interesting and important studies from SABCS 2021, including a downloadable highlights slideset, along with a CME-certified expert analysis activity where these experts will explore the clinical implications of the data.

Your Thoughts?
Which studies being presented at SABCS 2021 are you most interested in and think will have the biggest impact on clinical practice? Join the conversation below! 

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