New and improved technologies may be able to increase the speed and accuracy of detecting, diagnosing or monitoring breast cancer for progression and response to treatment.  

• Cerianna (Fluoroestradiol F-18) – A diagnostic imaging agent to detect estrogen-receptor (ER) positive breast cancer metastases
  • Doctors may use PET scans, or positron emission tomography, to scan for evidence that breast cancer has spread or metastasized. Once breast cancer has spread, the metastases may have evolved to a different type of breast cancer than the original tumor. These differences mean the metastases and the original tumor may not respond to the same treatments. A diagnostic imaging agent called Cerianna (fluoroestradiol F-18 or FES PET) allows doctors to use PET scans to learn if estrogen receptors are present in metastatic lesions. If a person has metastatic lesions that are estrogen receptor-positive, they may respond well to hormone therapy. This agent was recently incorporated in the National Comprehensive Cancer Network (NCCN) guidelines [6] as an option for some people with metastatic or recurrent estrogen receptor-positive breast cancer to consider [7]. 
• Targeting hibernating cancer cells
  • Dormant cancer cells are cells that did not die from a person’s initial treatment. These cells can “hibernate” undetected for unknown reasons until they begin to grow again. The bone is a common place for dormant breast cancer cells to hide and possibly grow. In the phase 2 CLEVER clinical trial [8], presented at the European Society of Clinical Oncology in October 2023 by Komen Scholar Dr. Angela DeMichele, researchers tested whether they could find dormant cancer cells in participants’ bone marrow and eliminate them. Study results showed researchers were able to find and remove dormant cancer cells from about 80% of the participants. While larger studies will be needed to confirm these results, the CLEVER study shows this promising approach may prevent breast cancer recurrence.
• HER2DX – A test to personalize treatment for HER2-positive breast cancer 
  • Doctors are getting closer to identifying which patients with early HER2-positive breast cancer can safely avoid chemotherapy by using the HER2DX genomic test. HER2DX is the first test specifically designed to identify HER2-positive patients at high and low risk for recurrence. For some people, being able to avoid chemotherapy without compromising long-term outcomes will lead to a better quality of life.  

With knowledge gained from clinical trials, researchers are seeking new ways to improve patient outcomes while using existing drugs. Some new breast cancer treatment breakthroughs are the result of combining certain drugs, finding which patients can skip certain elements of treatment or changing the order of their treatments to maximize effectiveness or minimize side effects.

• New immunotherapy approach in early triple negative breast cancer (TNBC) 
  • All people with early TNBC are currently treated with immunotherapy and chemotherapy prior to surgery, then they receive immunotherapy for up to 27 weeks after their surgery. A new phase 3 clinical trial called OptimICE-PCR led by Komen Scholar Dr. Sara Tolaney, will test a new approach. The study will determine whether simply observing patients is as effective as getting immunotherapy after surgery in preventing breast cancer from coming back, if their initial treatment successfully got rid of all the breast cancer [9]. While effective, immunotherapy comes with side effects and may not be needed in some treatment plans. This study will help identify who can safely de-escalate their immunotherapy treatment while maintaining good outcomes.
• More patients may benefit from trastuzumab deruxtecan (Enhertu)
  • Results from the phase 3 DESTINY-Breast06 clinical trial [10], presented at the American Society of Clinical Oncology (ASCO) meeting in June 2024, showed patients with metastatic estrogen receptor-positive (ER-positive), HER2-low and HER2-ultralow breast cancer had about a  5-month progression-free survival benefit with trastuzumab deruxtecan compared to chemotherapy. HER2-ultralow is a new designation and means that there is a very small amount of detectable HER2 in a tumor. Trastuzumab deruxtecan has already been shown to be effective in HER2-low metastatic breast cancer, but this is the first study showing that people with HER2-ultralow metastatic breast cancer may benefit as well. With these new findings, about 85% of patients with metastatic ER-positive breast cancer may become eligible for this treatment.
• New insights into pregnancy after breast cancer
  • New data from the Young Women’s Breast Cancer Study, led by Komen Chief Scientific Advisor Dr. Ann Partridge, found 73% of women with stage I-III breast cancer who attempted to get pregnant after completing their breast cancer treatment were successful. [11] This study, presented at the 2024 Annual ASCO meeting, is one of the most comprehensive studies attempting to answer this question to date. The results highlight the importance of making sure women have access to fertility preservation when they begin their breast cancer treatment.
• Personalizing chemotherapy for Black women 
  • Komen Scholar Dr. Bryan Schneider conducted the phase 2 EAZ171 clinical trial, which tested whether certain gene mutations could predict the likelihood of developing a side effect from some types of chemotherapy called taxane-induced peripheral neuropathy (TIPN), which is more common among Black women. This side effect causes pain, numbness and tingling in the extremities and can also lead to the treatment being stopped. Komen grantee Dr. Tarah Ballinger presented the results of the EAZ171 study at the 2024 Annual ASCO meeting. [12] The study found that while the gene mutations were unable to predict the likelihood of developing TIPN, researchers did identify a chemotherapy regimen that resulted in fewer instances of TIPN. These results provide some of the best evidence available to date to personalize chemotherapy treatment for Black women.