Future breast cancer care: ESMO Breast Cancer 2024
Transcript: Predicting pCR and survival in HER2+ breast cancer using HER2DX test
Professor Diana Lüftner
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Well, this conference, the ESMO Breast, is a conference of smaller details and out views. And there was one trial analysis that I really found very interesting on summarising data on gene array on HER2DX from different clinical trials. So, in short words, clinical adjuvant trials on anti-HER2 treatment were put together. And with the gene array, the analysis was done whether they could predict pathological complete remission or not. And in fact, HER2DX is really predicting whether a patient will develop a pathological complete remission. This is interesting because it would probably help us to escalate or deescalate treatment based on HER2DX result, things that we have not been able to do so far. Well, what is a potential for escalation? For instance, and I refer to a poster that I presented myself as a co-author at the ESMO Breast, the ELEANOR trial, which is a trial done in Germany and Austria and Switzerland, really focusing on the compliance to neratinib, an anti-HER2 tyrosine kinase inhibitor. And what we have seen here is that really the clinicians select the patients on their individual assessment of risk factors, which is really nodal involvement and Ki-67, and of course non-PCR. If we could get some help by, in HER2DX assay, we would make this selection more objective. The only caveat that I have that at the ESMO Breast, there was no distinction done between hormone receptor positive, HER2 positive breast cancer patients, and just HER2 positive and hormone receptor negative patients. The next thing that I found very interesting was a kind of link of ESMO Breast to ESMO last year done by Peter Schmid. At the ESMO last year, he presented data from the BEGONIA trial combining durvalumab with an ADC. And this time, this year, he presented SG with atezolizumab in metastatic triple negative breast cancer. And what we have seen here that there is an increase of response rate and duration of response and other parameters indicating that maybe it would make sense to combine an ADC together with a checkpoint inhibitor. And by the way, I think I forgot, in the BEGONIA trial, it was the datopotamab deruxtecan that was combined here with durvalumab. So, we have two phase one two trials where this strategy was combined. And I think the idea of doing this and putting back again further lines of chemotherapy would be interesting.
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