This year’s American Society of Clinical Oncology (ASCO) Annual Meeting showcased the latest groundbreaking discoveries and new treatments that could change the landscape of breast cancer care. In this episode of Breast Cancer Breakthroughs, we speak with Komen grantees Dr. Tarah Ballinger, medical oncologist at Indiana University School of Medicine, and Dr. Pedram Razavi, medical oncologist at Memorial Sloan Kettering Cancer Center, about the biggest highlights from the 2024 ASCO Annual Meeting and what they could mean for patients.
Improving Treatment Personalization for Black Women
One of the most anticipated studies featured at ASCO this year was the EAZ171 trial, which sought new ways to reduce toxic side effects from some types of chemotherapy in Black women with early-stage breast cancer. Komen Scholar Bryan Schneider, M.D., who is leading the trial, has been investigating how Black women are prone to a painful side effect of chemotherapy called taxane-induced peripheral neuropathy (TIPN).
Dr. Tarah Ballinger, who presented the results at ASCO, explains that Black women who receive certain taxanes, or chemotherapy drugs, have worse survival rates from their breast cancer and higher rates of TIPN.
“Peripheral neuropathy from taxanes like docetaxel or paclitaxel impact quality of life, but are also the primary reason for dose reductions of therapy,” she explains. “So, it can impact survival as well, particularly for Black patients.”
The EAZ171 study found patients treated with docetaxel experienced less neuropathy or fewer dose reductions than those who received paclitaxel. Through this study, Dr. Schneider and his team also hoped to identify genetic biomarkers in participants that would show who might be at higher risk for TIPN.
While no biomarkers have been identified yet, the EAZ171 study provides earlyevidence that docetaxel is a preferable chemotherapy treatment for Black patients with early-stage breast cancer. It also demonstrates how studies can be designed to better evaluate disparities in patients who are typically underrepresented in clinical trials, like the Black community.
Personalizing Treatment for Metastatic ER+ Breast Cancer
Other exciting study results shared at ASCO also focused on the need for more personalized treatments for estrogen receptor-positive (ER+) metastatic breast cancer (MBC), including the DESTINY-Breast06 trial.
DESTINY-Breast06 studiedthe effectiveness of an antibody-drug conjugate (ADC) called trastuzumab deruxtecan (Enhertu) compared to chemotherapy for patients with metastatic ER+ breast cancer who had already progressed on endocrine therapy. When used as a first line of treatment, trastuzumab deruxtecan improved progression-free survival over chemotherapy, and showed potential to improve long-term survival. The study also showed for the first time that patients with HER2-ultra-low breast cancer, or tumors with very little HER2 expression, could also benefit from this drug.
Other study results presented at ASCO like the INAVO120 trial and the postMONARCH trial showed even more improved treatments could be on the horizon for patients with ER+ MBC. “We are getting more and more options for ER+ MBC, and we just have to work on how to sequence them and how to individualize who needs what and when,” Dr. Ballinger says.
More Biomarkers Needed for Treatment Personalization
While many of the latest clinical trials promise exciting new treatment options, researchers are aware that advances are still needed to personalize these treatments for patients. Komen grantee Dr. Pedram Razavi, who also attended and presented at ASCO, explains new biomarkers are needed to select the right drug for the right person, especially for ADCs like trastuzumab deruxtecan.
“There were some good studies and some good presentations at ASCO just highlighting the fact that we need better biomarkers,” Dr. Razavi explains. “We need to be able to select between which one of these ADCs I should offer the patient. Should I offer an HER2 ADC with this payload, or should I go for another?”
Dr. Razavi is also excited about the potential of using liquid biopsies. He discussed a study that showed the potential for using circulating tumor DNA or ctDNA, to predict patient outcomes.
“Every time we have better tools like liquid biopsies, other biomarkers can be used to identify the patients better, stratify them and offer them more effective treatments as we see them in clinic,” he says. “I think it’s an exciting time.”
Embracing the Patient Perspective
The patient voice is vital to the research process and plays a large role in how future research studies are designed.
“I think our patients are maybe the most important partners in the research that we do,” Dr. Ballinger says. “It’s always good to hear the patient feedback, and have the patients come back to inform what our next research priorities should be in that space.”
For patient advocate Jamie LaScala, ASCO also provides a front row seat to the newest guidelines and standards that come from this critical work. As a member of one of ASCO’s guideline committees, Jamie has the opportunity to view the updated guidelines and recommendations that result from ASCO and are passed on to healthcare providers.
“Our hope definitely lies in research,” she says, “and we appreciate the opportunity to partner with researchers on behalf of the broader patient community.”
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If you’d like more information about choosing a clinical trial, BreastCancerTrials.org, in collaboration with Susan G. Komen®, offers a custom matching service to help find clinical trials that fit your needs.
