Every year, the San Antonio Breast Cancer Symposium (SABCS) brings together thousands of doctors, researchers and patient advocates to discuss the latest, practice-changing advances in breast cancer research and care. SABCS 2024 was no exception. At this year’s symposium, new research was announced that has the potential to change clinical practice for a wide range of people with breast cancer.
Komen staff member Laurel Pointer has attended SABCS before, but this year was her first time as a breast cancer survivor.
“This is taking on a really different perspective for me. I’m here and I’m so excited about all the breakthroughs and things that are happening as a patient,” says Pointer.
Advances in Metastatic Breast Cancer (MBC)
Oral selective estrogen receptor degraders (SERDs) are a type of hormone therapy and are being developed at a rapid pace. Data from the phase 3 EMBER-3 clinical trial was presented about a new investigational oral SERD called imlunestrant. The study showed that imlunestrant alone reduced the risk of cancer progression by 38% compared to standard hormone therapy in patients whose cancer had an ESR1 mutation. The study also showed that when combined with the CDK4/6 inhibitor drug abemaciclib, imlunestrant reduced the risk of cancer progression by 43% in all patients compared to imlunestrant alone. Pending FDA-approval, imlunestrant could be a new treatment option for people with metastatic hormone receptor-positive (HR+) breast cancer.
About 10% of all breast cancers are hormone receptor-positive (HR+)/HER2-positive (HER2+). While CDK4/6 inhibitors are standard of care for treatment for metastatic HR+ breast cancer, they are not currently used to treat metastatic HR+/HER2+ breast cancer. However, the results from the phase 3 AFT-38 PATINA trial announced at SABCS may change this. The study showed that combining the CDK4/6 inhibitor drug, palbociclib, to standard hormone therapy, plus HER2-targeted therapy led to a median of 44.3 months without cancer progression in trial participants, compared to 29.1 months for those treated with hormone therapy and HER2-targeted therapy alone.
Right-Sizing Management of DCIS
Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer that may or may not progress to invasive breast cancer. It’s typically treated with surgery, with or without radiation and/or hormone therapy to prevent progression to invasive breast cancer. However, it is suspected that many cases of DCIS are overtreated. The phase 3 COMET study tested if active monitoring of low-risk DCIS is as effective as standard treatment in preventing progression to breast cancer. The results showed no difference in breast cancer recurrence rates after 2 years of monitoring. Notably, the majority of participants received hormone therapy to prevent progression. Further, patient-reported outcomes from the study presented by Komen Chief Scientific Advisor Dr. Ann Partridge showed there was no difference in quality of life for either group. These results suggest that avoiding surgery and radiation may be a viable option for managing some cases of low-risk DCIS.
New insights into Breast Cancers with a BRCA-inherited Genetic Mutation
Olaparib was FDA-approved to treat high-risk early breast cancer in people with inherited BRCA1/2 genetic mutations in 2022 based on the results of the phase 3 OlympiA trial. New results from the trial presented at SABCS found that after a median of 6 years of follow-up, participants who took olaparib for one year continue to have better outcomes than those who received a placebo, with 79.6% of participants showing no evidence of disease after olaparib treatment compared to 70.3% of participants treated with a placebo. The results confirm that olaparib is an effective treatment for patients with high-risk, HER2-negative breast cancer with BRCA mutations.
Another study examined the benefit of risk-reducing mastectomies or salpingo-oophorectomies (removal of fallopian tubes and ovaries) in 5,290 young women with breast cancer who have BRCA1/2 genetic mutations. The results demonstrated that these surgeries significantly improved overall survival and disease-free survival. Results from this study may help launch discussions between young women and their doctors about the most appropriate risk-reducing treatment plan for them.
Progress for Patients
From early detection to MBC, the research announced at SABCS 2024 represents progress for breast cancer patients across the board. Many of these results have the potential to change clinical practice, meaning that doctors are getting better at personalizing care and ensuring everyone with breast cancer is getting the best treatment for their unique experience.
According to Pointer, “I’m seeing the scientists and researchers talk about what they’re doing, the breakthroughs that they’re having, the developments, cancer treatmentsand how it’s making a difference today in my life.”
