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Open Access 14-04-2025 | Breast Cancer | short review

ESMO 2024: highlights in breast cancer

Authors: Simon Udovica, Muna Ferner, Maximilian Marhold, Kathrin Strasser-Weippl, Rupert Bartsch

Published in: memo - Magazine of European Medical Oncology

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Summary

Several clinically relevant abstracts in the field of breast cancer (BC) were presented during the 2024 congress of the European Society for Medical Oncology (ESMO). Updates from the phase 3 NATALEE trial supported the role of cyclin-dependent kinase (CDK) 4/6 inhibitors in early-stage hormone-receptor (HR)-positive/HER2-negative breast cancer with intermediate to high risk of recurrence, while an update of KEYNOTE-522 reported an overall survival (OS) benefit with pembrolizumab in early-stage triple-negative disease. In HER2-positive early-stage BC, the phase 2 WSG-TP-II trial reported excellent long-term outcomes with de-escalated neoadjuvant chemotherapy combined with trastuzumab and pertuzumab. A retrospective analysis of endocrine treatment strategies in the pivotal HERA trial emphasized the importance of ovarian function suppression (OFS) in premenopausal patients with HR-positive/HER2-positive disease, even in the presence of HER2-directed treatments. Antibody–drug conjugates (ADCs) remain a key focus of scientific interest. Results from DESTINY-Breast12 support the use of trastuzumab deruxtecan (T-DXd) in metastatic HER2-positive BC patients with active brain metastases (BM), showing high response rates and prolonged disease control in this phase 3b/4 study. The single-arm phase 2 ICARUS-Breast01 trial demonstrated promising results of the HER3-directed ADC patritumab deruxtecan in pretreated patients with metastatic luminal disease. Biological differences between HR-positive/HER2-positive and HR-negative/HER2-positive BC are evident, and DETECT V questions the need for chemotherapy while corroborating previous data supporting the role of CDK 4/6 inhibitors in patients with HR-positive/HER2-positive disease. In patients with metastatic triple-negative breast cancer (TNBC), bispecific antibodies co-targeting PD‑1 or PD-L1 and VEGF showed promising results. Despite sound clinical rationale, inhibition of the PI3K/AKT/mTOR pathway in metastatic TNBC remained unsuccessful in the CAPItello-290 trial.
Literature
1.
go back to reference Fasching PA, et al. LBA13 Adjuvant ribociclib (RIB) plus nonsteroidal aromatase inhibitor (NSAI) in patients (Pts) with HR+/HER2−early breast cancer (EBC): 4‑year outcomes from the NATALEE trial. Ann Oncol. 2024;35:S1207.CrossRef Fasching PA, et al. LBA13 Adjuvant ribociclib (RIB) plus nonsteroidal aromatase inhibitor (NSAI) in patients (Pts) with HR+/HER2−early breast cancer (EBC): 4‑year outcomes from the NATALEE trial. Ann Oncol. 2024;35:S1207.CrossRef
2.
go back to reference Rastogi P, et al. Adjuvant Abemaciclib plus endocrine therapy for hormone receptor-positive, human epidermal growth factor receptor 2‑negative, high-risk early breast cancer: results from a preplanned monarchE overall survival interim analysis, including 5‑year efficacy outcomes. J Clin Oncol. 2024;42:987–93.CrossRefPubMedPubMedCentral Rastogi P, et al. Adjuvant Abemaciclib plus endocrine therapy for hormone receptor-positive, human epidermal growth factor receptor 2‑negative, high-risk early breast cancer: results from a preplanned monarchE overall survival interim analysis, including 5‑year efficacy outcomes. J Clin Oncol. 2024;42:987–93.CrossRefPubMedPubMedCentral
3.
go back to reference Fabiano V, et al. Breast cancer in young women presents with more aggressive pathologic characteristics: retrospective analysis from an Argentine national database. JCO Glob Oncol. 2020;6:639–46.CrossRefPubMed Fabiano V, et al. Breast cancer in young women presents with more aggressive pathologic characteristics: retrospective analysis from an Argentine national database. JCO Glob Oncol. 2020;6:639–46.CrossRefPubMed
4.
go back to reference Loi S, et al. 235MO Efficacy and safety of ribociclib (RIB) + nonsteroidal aromatase inhibitor (NSAI) in younger patients (pts) with HR+/HER2− early breast cancer (EBC) in NATALEE. Ann Oncol. 2024;35:S310–S1.CrossRef Loi S, et al. 235MO Efficacy and safety of ribociclib (RIB) + nonsteroidal aromatase inhibitor (NSAI) in younger patients (pts) with HR+/HER2− early breast cancer (EBC) in NATALEE. Ann Oncol. 2024;35:S310–S1.CrossRef
5.
go back to reference Schmid P, et al. Event-free survival with pembrolizumab in early triple-negative breast cancer. N Engl J Med. 2022;386:556–67.CrossRefPubMed Schmid P, et al. Event-free survival with pembrolizumab in early triple-negative breast cancer. N Engl J Med. 2022;386:556–67.CrossRefPubMed
6.
go back to reference Schmid P, et al. Overall survival with pembrolizumab in early-stage triple-negative breast cancer. N Engl J Med. 2024;391:1981–91.CrossRefPubMed Schmid P, et al. Overall survival with pembrolizumab in early-stage triple-negative breast cancer. N Engl J Med. 2024;391:1981–91.CrossRefPubMed
7.
go back to reference Gluz O, et al. Efficacy of endocrine therapy plus trastuzumab and pertuzumab vs de-escalated chemotherapy in patients with hormone receptor-positive/ERBB2-positive early breast cancer: the Neoadjuvant WSG-TP-II randomized clinical trial. JAMA Oncol. 2023;9:946–54.CrossRefPubMedPubMedCentral Gluz O, et al. Efficacy of endocrine therapy plus trastuzumab and pertuzumab vs de-escalated chemotherapy in patients with hormone receptor-positive/ERBB2-positive early breast cancer: the Neoadjuvant WSG-TP-II randomized clinical trial. JAMA Oncol. 2023;9:946–54.CrossRefPubMedPubMedCentral
8.
go back to reference Gluz O, et al. LBA17 Survival outcome of neoadjuvant endocrine therapy + trastuzumab and pertuzumab (ET+T+P) vs. de-escalated chemotherapy (CT)+T+P in hormone receptor positive (HR+)/HER2+ early breast cancer (EBC): WSG-TP-II trial. Ann Oncol. 2024;35:S1210.CrossRef Gluz O, et al. LBA17 Survival outcome of neoadjuvant endocrine therapy + trastuzumab and pertuzumab (ET+T+P) vs. de-escalated chemotherapy (CT)+T+P in hormone receptor positive (HR+)/HER2+ early breast cancer (EBC): WSG-TP-II trial. Ann Oncol. 2024;35:S1210.CrossRef
9.
go back to reference Piccart-Gebhart MJ, et al. Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med. 2005;353:1659–72.CrossRefPubMed Piccart-Gebhart MJ, et al. Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med. 2005;353:1659–72.CrossRefPubMed
10.
go back to reference Cameron D, et al. 11 years’ follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive early breast cancer: final analysis of the HERceptin Adjuvant (HERA) trial. Lancet. 2017;389:1195–205.CrossRefPubMedPubMedCentral Cameron D, et al. 11 years’ follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive early breast cancer: final analysis of the HERceptin Adjuvant (HERA) trial. Lancet. 2017;389:1195–205.CrossRefPubMedPubMedCentral
11.
go back to reference Moon S, et al. 233MO ovarian function suppression in HR-positive, HER2-positive breast cancer: an exploratory analysis from the HERA trial. Ann Oncol. 2024;35:S310.CrossRef Moon S, et al. 233MO ovarian function suppression in HR-positive, HER2-positive breast cancer: an exploratory analysis from the HERA trial. Ann Oncol. 2024;35:S310.CrossRef
12.
go back to reference Schmid D, Leitzmann MF. Association between physical activity and mortality among breast cancer and colorectal cancer survivors: a systematic review and meta-analysis. Ann Oncol. 2014;25:1293–311.CrossRefPubMed Schmid D, Leitzmann MF. Association between physical activity and mortality among breast cancer and colorectal cancer survivors: a systematic review and meta-analysis. Ann Oncol. 2014;25:1293–311.CrossRefPubMed
13.
go back to reference Rundqvist H, Rietz M, Mijwel S, Lindström LS, Wengström Y. 232O effects of a high-intensity exercise intervention on recurrence and survival: the Optitrain breast cancer trial. Ann Oncol. 2024;35:S309.CrossRef Rundqvist H, Rietz M, Mijwel S, Lindström LS, Wengström Y. 232O effects of a high-intensity exercise intervention on recurrence and survival: the Optitrain breast cancer trial. Ann Oncol. 2024;35:S309.CrossRef
14.
go back to reference Bartsch R, et al. Trastuzumab deruxtecan in HER2-positive breast cancer with brain metastases: a single-arm, phase 2 trial. Nat Med. 2022;28:1840–7.CrossRefPubMedPubMedCentral Bartsch R, et al. Trastuzumab deruxtecan in HER2-positive breast cancer with brain metastases: a single-arm, phase 2 trial. Nat Med. 2022;28:1840–7.CrossRefPubMedPubMedCentral
15.
go back to reference Pérez-García JM, et al. Trastuzumab deruxtecan in patients with central nervous system involvement from HER2-positive breast cancer: the DEBBRAH trial. Neuro Oncol. 2023;25:157–66.CrossRefPubMed Pérez-García JM, et al. Trastuzumab deruxtecan in patients with central nervous system involvement from HER2-positive breast cancer: the DEBBRAH trial. Neuro Oncol. 2023;25:157–66.CrossRefPubMed
16.
go back to reference Niikura N, et al. Treatment with trastuzumab deruxtecan in patients with HER2-positive breast cancer and brain metastases and/or leptomeningeal disease (ROSET-BM). Npj Breast Cancer. 2023;9:1–8.CrossRef Niikura N, et al. Treatment with trastuzumab deruxtecan in patients with HER2-positive breast cancer and brain metastases and/or leptomeningeal disease (ROSET-BM). Npj Breast Cancer. 2023;9:1–8.CrossRef
17.
go back to reference André F, et al. A pooled analysis of trastuzumab deruxtecan in patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer with brain metastases. Ann Oncol. 2024;35:1169–80.CrossRefPubMed André F, et al. A pooled analysis of trastuzumab deruxtecan in patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer with brain metastases. Ann Oncol. 2024;35:1169–80.CrossRefPubMed
18.
go back to reference Harbeck N, et al. Trastuzumab deruxtecan in HER2-positive advanced breast cancer with or without brain metastases: a phase 3b/4 trial. Nat Med. 2024;30:3717–27.CrossRefPubMedPubMedCentral Harbeck N, et al. Trastuzumab deruxtecan in HER2-positive advanced breast cancer with or without brain metastases: a phase 3b/4 trial. Nat Med. 2024;30:3717–27.CrossRefPubMedPubMedCentral
19.
go back to reference Berghoff AS, et al. Co-overexpression of HER2/HER3 is a predictor of impaired survival in breast cancer patients. Breast. 2014;23:637–43.CrossRefPubMed Berghoff AS, et al. Co-overexpression of HER2/HER3 is a predictor of impaired survival in breast cancer patients. Breast. 2014;23:637–43.CrossRefPubMed
20.
go back to reference Papa F, et al. Long road towards effective HER3 targeting in breast cancer. Cancer Treat Rev. 2024;129. Papa F, et al. Long road towards effective HER3 targeting in breast cancer. Cancer Treat Rev. 2024;129.
21.
go back to reference Krop IE, et al. Patritumab deruxtecan (HER3-DXd), a human epidermal growth factor receptor 3‑directed antibody-drug conjugate, in patients with previously treated human epidermal growth factor receptor 3‑expressing metastatic breast cancer: a multicenter, phase I/II trial. J Clin Oncol. 2023;41:5550–60.CrossRefPubMedPubMedCentral Krop IE, et al. Patritumab deruxtecan (HER3-DXd), a human epidermal growth factor receptor 3‑directed antibody-drug conjugate, in patients with previously treated human epidermal growth factor receptor 3‑expressing metastatic breast cancer: a multicenter, phase I/II trial. J Clin Oncol. 2023;41:5550–60.CrossRefPubMedPubMedCentral
22.
go back to reference Pistilli B, et al. 340O Efficacy, safety and biomarker analysis of ICARUS-BREAST01: a phase II study of patritumab deruxtecan (HER3-DXd) in patients (pts) with HR+/HER2− advanced breast cancer (ABC). Ann Oncol. 2024;35:S357.CrossRef Pistilli B, et al. 340O Efficacy, safety and biomarker analysis of ICARUS-BREAST01: a phase II study of patritumab deruxtecan (HER3-DXd) in patients (pts) with HR+/HER2− advanced breast cancer (ABC). Ann Oncol. 2024;35:S357.CrossRef
23.
go back to reference Tolaney SM, et al. Abemaciclib plus trastuzumab with or without fulvestrant versus trastuzumab plus standard-of-care chemotherapy in women with hormone receptor-positive, HER2-positive advanced breast cancer (monarcHER): a randomised, open-label, phase 2 trial. Lancet Oncol. 2020;21:763–75.CrossRefPubMed Tolaney SM, et al. Abemaciclib plus trastuzumab with or without fulvestrant versus trastuzumab plus standard-of-care chemotherapy in women with hormone receptor-positive, HER2-positive advanced breast cancer (monarcHER): a randomised, open-label, phase 2 trial. Lancet Oncol. 2020;21:763–75.CrossRefPubMed
24.
go back to reference Ciruelos E, et al. Primary results from PATRICIA cohort C (SOLTI-1303), a randomized phase II study evaluating palbociclib with trastuzumab and endocrine therapy in pretreated HER2-positive and PAM50 luminal advanced breast cancer. J Clin Oncol. 2024;42:1008–1008.CrossRef Ciruelos E, et al. Primary results from PATRICIA cohort C (SOLTI-1303), a randomized phase II study evaluating palbociclib with trastuzumab and endocrine therapy in pretreated HER2-positive and PAM50 luminal advanced breast cancer. J Clin Oncol. 2024;42:1008–1008.CrossRef
25.
go back to reference Janni W, et al. 350MO Omission of chemotherapy and addition of the CDK4/6 inhibitor ribociclib in HER2-positive and hormone-receptor positive metastatic breast cancer—Second interim efficacy analysis of the randomized phase III DETECT V trial. Ann Oncol. 2024;35:S362.CrossRef Janni W, et al. 350MO Omission of chemotherapy and addition of the CDK4/6 inhibitor ribociclib in HER2-positive and hormone-receptor positive metastatic breast cancer—Second interim efficacy analysis of the randomized phase III DETECT V trial. Ann Oncol. 2024;35:S362.CrossRef
26.
go back to reference Metzger, O., Mandrekar, S., DeMichele, A., et al. J. AFT-38 PATINA: A Randomized, Open Label, Phase III Trial to Evaluate the Efficacy and Safety of Palbociclib + Anti-HER2 Therapy + Endocrine Therapy vs. Anti-HER2 Therapy + Endocrine Therapy after Induction Treatment for Hormone Receptor-Positive (HR+)/HER2-Positive Metastatic Breast Cancer. 2024 San Antonio Breast Cancer Symposium. Abstract P2-03-20 (SESS-18111). Presented December 10, 2024. Metzger, O., Mandrekar, S., DeMichele, A., et al. J. AFT-38 PATINA: A Randomized, Open Label, Phase III Trial to Evaluate the Efficacy and Safety of Palbociclib + Anti-HER2 Therapy + Endocrine Therapy vs. Anti-HER2 Therapy + Endocrine Therapy after Induction Treatment for Hormone Receptor-Positive (HR+)/HER2-Positive Metastatic Breast Cancer. 2024 San Antonio Breast Cancer Symposium. Abstract P2-03-20 (SESS-18111). Presented December 10, 2024.
28.
go back to reference Schmid P, et al. LBA19 Capivasertib (C) + paclitaxel (P) as first-line treatment of metastatic triple-negative breast cancer (mTNBC): The CAPItello-290 phase III trial. Ann Oncol. 2024;35:S1212–S3.CrossRef Schmid P, et al. LBA19 Capivasertib (C) + paclitaxel (P) as first-line treatment of metastatic triple-negative breast cancer (mTNBC): The CAPItello-290 phase III trial. Ann Oncol. 2024;35:S1212–S3.CrossRef
29.
go back to reference Ouyang Q, et al. 347MO The safety and efficacy of ivonescimab in combination with chemotherapy as first-line (1L) treatment for triple-negative breast cancer (TNBC). Ann Oncol. 2024;35:S360–S1.CrossRef Ouyang Q, et al. 347MO The safety and efficacy of ivonescimab in combination with chemotherapy as first-line (1L) treatment for triple-negative breast cancer (TNBC). Ann Oncol. 2024;35:S360–S1.CrossRef
30.
go back to reference Wu J, et al. 348MO A phase Ib/II study to assess the safety and efficacy of PM8002/BNT327 in combination with nab-paclitaxel for first-line treatment of locally advanced or metastatic triple-negative breast cancer. Ann Oncol. 2024;35:S361.CrossRef Wu J, et al. 348MO A phase Ib/II study to assess the safety and efficacy of PM8002/BNT327 in combination with nab-paclitaxel for first-line treatment of locally advanced or metastatic triple-negative breast cancer. Ann Oncol. 2024;35:S361.CrossRef
Metadata
Title
ESMO 2024: highlights in breast cancer
Authors
Simon Udovica
Muna Ferner
Maximilian Marhold
Kathrin Strasser-Weippl
Rupert Bartsch
Publication date
14-04-2025
Publisher
Springer Vienna
Published in
memo - Magazine of European Medical Oncology
Print ISSN: 1865-5041
Electronic ISSN: 1865-5076
DOI
https://doi.org/10.1007/s12254-025-01028-5

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