Future breast cancer care: ESMO Breast Cancer 2024
Transcript: Future developments in breast cancer treatment: ART and CDK4/6i
Professor Michael Gnant
All transcripts are created from interview footage and directly reflect the content of the interview at the time. The content is that of the speaker and is not adjusted by Medthority.
Even with breakthrough stuff, which we need to apply tomorrow, missing this year's ESMO Breast, I think there is clinically relevant information there. For example, very interesting. I mean, it's a niche subject. It's only a very small number of patients affected, but still, for them, it's a very important issue. That's breast cancer and pregnancy. And Matteo Lambertini presented a very large study, a cohort study, of 20 years of patients who even had assisted reproduction techniques in order to support their pregnancies. And so this was even a BRCA-mutated population. And the clinically relevant result of that is even that that is only a very small proportion in terms of numbers, but it's hugely emotional subject. But those affected, those very young patients, where the breast cancer gets in the way of their family planning. And the clear-cut result of that cohort study is that even when you use assisted reproduction support in such a situation, that number one, this can be successful. So there is quite a number of pregnancies without impacting the health of the newborn babies. So it is safe to do that, and it appears to be also safe from an oncological point of view. So these patients do not pay a price, so to say, in terms of increased recurrence of something. And I think, you know, while we have been more generous and liberal than historically with breast cancer and pregnancies, that's a subject, using assisted reproduction technologies, that many clinicians around the world would still be a little bit reluctant, or let's say cautious at least. And it's very reassuring to see that we can do this without harming the patient or the newborn babies. I think that's a clinically relevant result. Also for the future, it's not quite ready for prime time, but in the second half of the year, we will see approval for ribociclib as the CDK4/6 inhibitor in the adjuvant setting for an enlarged patient population, not only highest risk, low positive patients, but ranging or extending into stage two. And for this pain, obviously, every addition of treatment also has tolerability and toxicity issues. And I think the update of the NATALEE trial, presented by my friend Carlos Barrios from Brazil, clearly showed that even when you dose, when you are forced to do dose reductions with adjuvant ribociclib, that you will preserve the benefit for patients, which I also believe is reassuring. In most healthcare environments, that's not yet available, but it will become available in the second half of 2024.
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