eCase - 2022 SABCS Highlights

Introduction

In this module, Joyce O’Shaughnessy, MD, and Sara A. Hurvitz, MD, FACP, discuss key findings in breast cancer presented at the 2022 San Antonio Breast Cancer Symposium (SABCS), including updates in early-stage, hormone receptor (HR)–positive, and HER2-positive disease.

Please note that the key points discussed in this module are illustrated with thumbnails from the accompanying downloadable PowerPoint slidesets, which can be found here or downloaded by clicking any of the slide thumbnails in the module alongside the expert commentary.

Clinical Care Options plans to measure the educational impact of this activity. A few questions will be asked twice: once at the beginning of the activity and then once again after the discussion that informs the best choice. Your responses will be aggregated for analysis, and your specific responses will not be shared.

Before continuing with this educational activity, please take a moment to answer the following questions.

If you are a practicing healthcare professional, how many patients with breast cancer do you provide care for in a typical month?

A. <5
B. 5-10
C. 11-15
D. 16-20
E. >20

The phase III monarchE trial compared 2 years of adjuvant abemaciclib plus endocrine therapy (ET) with ET alone in patients with high-risk, node-positive, HR-positive/HER2-negative early breast cancer. Which of the following statements accurately reflects outcomes from the 4-year updated analysis presented at SABCS 2022?

A.
Transient improvement of invasive disease-free survival (iDFS) with abemaciclib in the overall population that is lost after treatment discontinuation
B.
Durable improvement of iDFS with abemaciclib in the overall population that is maintained after treatment discontinuation
C.
Transient improvement of iDFS with abemaciclib only in the high Ki-67 population that is lost after treatment discontinuation
D.
Durable improvement of iDFS with abemaciclib only in the high Ki-67 population that is maintained after treatment discontinuation

The CAPItello-291 trial compared the oral AKT inhibitor capivasertib plus fulvestrant vs placebo plus fulvestrant for patients with HR-positive/HER2-negative advanced breast cancer resistant to aromatase inhibitor (AI) therapy. Which of the following progression-free survival (PFS) outcomes was reported with capivasertib plus fulvestrant vs the control arm in this study?

A.
Significant improvement in median PFS in the AKT pathway–altered population but not in the overall patient population
B.
Significant improvement in median PFS in both the AKT pathway–altered and overall patient populations
C.
No PFS benefit for patients who had received a previous CDK4/6 inhibitor
D.
No PFS benefit for patients with liver metastases

Based on the recent analysis by Rugo and colleagues of the TROPiCs-02 trial of sacituzumab govitecan vs physician’s choice of single-agent chemotherapy for previously treated patients with HR-positive/HER2-negative metastatic breast cancer showing improved outcomes with sacituzumab govitecan, what tumor Trop-2 expression level by immunohistochemistry (H-score) would you use to identify patients with HR-positive/HER2-negative metastatic breast cancer as candidates for this antibody-drug conjugate?

A.
≥100
B.
≥20
C.
≥10
D.
≥1
E.
Testing is not required

For a patient with metastatic HER2-positive breast cancer and progression of visceral metastases on first-line docetaxel/trastuzumab/pertuzumab, which of the following best describes the preferred second-line therapy option based on the updated efficacy and safety data from the DESTINY-Breast03 phase III trial of trastuzumab emtansine (T-DM1) compared with trastuzumab deruxtecan (T-DXd) reported by Hurvitz and colleagues?

A.
T-DM1 is preferred for most patients based on a similar median PFS and better tolerability
B.
T-DXd is preferred for most patients based on improved median PFS and OS
C.
Either T-DM1 or T-DXd is reasonable, based on a similar clinical benefit rate reported for both
D.
Either T-DM1 or T-DXd is reasonable, based on a similar median OS reported for both

Which of the following best describes the central nervous system (CNS) response outcomes of the TBCRC 022 trial evaluating the combination of neratinib and T-DM1 in patients with brain metastases?

A.
CNS activity observed in patients with previously untreated brain metastases only
B.
CNS activity observed in patients with progressing brain metastases after tucatinib therapy
C.
CNS activity observed in patients with progressing brain metastases and no previous T-DM1 only
D.
CNS activity observed in patients with previously untreated or progressive brain metastases with or without previous T-DM1

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Highlights From the 2022 San Antonio Breast Cancer Symposium

Sara A. Hurvitz, MD

Joyce O'Shaughnessy, MD

Activity

Introduction

If you are a practicing healthcare professional, how many patients with breast cancer do you provide care for in a typical month?

Which of the following best describes the central nervous system (CNS) response outcomes of the TBCRC 022 trial evaluating the combination of neratinib and T-DM1 in patients with brain metastases?