SABCS 2022 Takeaways - 9

CLINICAL TRIALS UPDATES 9
ASKED AND ANSWERED
Q
A
Sara A. Hurvitz, MD, FACP
DESTINY-Breast03 (GS2-02)
S
tudy presenter, Sara A. Hurvitz, MD, FACP, said that in
DESTINY-Breast03, when compared with trastuzumab emtansine,
T-DM1, " T-DXd reduced the risk of death by 36%, and
the median progression-free survival was four times longer
than with TDM-1; 78.5% of patients experienced a confirmed
objective response, and 1 in 5 patients treated with T-DXd had
a complete response. With longer treatment duration, T-DXd
continued to demonstrate a manageable safety profile, similar
rates of grade 3/4 adverse events, and no grade 4/5 adjudicated
drug-related interstitial lung disease or pneumonitis. "
Novel Agents: SERDs
Selective estrogen receptor degraders (SERDs) antagonize
and destabilize the estrogen receptor, leading to its
inhibition and degradation. Because the only SERD currently
approved by the U.S. Food and Drug Administration for breast
cancer, fulvestrant, must be given via injection in a physician's
office, much attention is being given to the development of
second-generation SERDs that are given orally and that are
more effective in situations of ER-acquired resistance developed
through a mutation in ESR1.
EMERALD (GS3-01)
" E
MERALD is the only pivotal phase III trial of an
oral SERD with 100% prior CDK4/6 inhibitor
usage. Longer duration of prior CDK4/6 therapy in
the metastatic setting associated with longer progression-free
survival on elacestrant vs. standard
of care. Patients whose tumor harbored an ESR1
mutation who had at least 12 months of prior CDK4/6
inhibitor achieved a median PFS of 8.6 months with
elacestrant vs. 2 months with standard of care. No
new safety signals were identified.
These updated results demonstrate that monotherapy
use of elacestrant is safe and meaningful extends
landmark progression-free survival rates. Elacestrant
can become an important oral endocrine monotherapy
in the second- and third-line [settings] as an
alternative to combination therapies that are associated
with challenging safety events. "
-Virginia Kaklamani, MD, SABCS 2022
co-chair and presenter
Read the full phase III
EMERALD trial results in the
Journal of Clinical Oncology
Virginia Kaklamani, MD
SABCSMEETINGNEWS . ORG
Carlos L. Arteaga, MD: Can patients
who develop these toxicities [of ILD and
pneumonitis] be retreated later on?
Dr. Sara A. Hurvitz: It is interesting that the
rate of all-grade ILD did increase with this
longer duration. What's notable are the lack
of deaths and lack of grade-4 events. I think
we're becoming better at catching ILD early
when it's asymptomatic. We hold therapy for
asymptomatic grade-1 ILD that is only seen on
scans, and we don't resume until it's resolved.
With grade 2, we completely stop therapy and
don't resume-it's a hard stop now. There are
investigations looking at whether we can safely
retreat patients who had grade-2 ILD that then
resolved, but that should only be done in the
context of a clinical trial. We should, as clinicians,
continue to follow CT scans of the lungs
closely for patients being treated with T-DXd
because this is an event that can occur even up
to a year or longer of therapy. "

https://ascopubs.org/doi/10.1200/JCO.22.00338?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed https://www.sabcs.org/ https://www.sabcsmeetingnews.org/

SABCS 2022 Takeaways

Table of Contents for the Digital Edition of SABCS 2022 Takeaways

SABCS 2022 Takeaways - A
SABCS 2022 Takeaways - 1
SABCS 2022 Takeaways - 2
SABCS 2022 Takeaways - 3
SABCS 2022 Takeaways - 4
SABCS 2022 Takeaways - 5
SABCS 2022 Takeaways - 6
SABCS 2022 Takeaways - 7
SABCS 2022 Takeaways - 8
SABCS 2022 Takeaways - 9
SABCS 2022 Takeaways - 10
SABCS 2022 Takeaways - 11
SABCS 2022 Takeaways - 12
SABCS 2022 Takeaways - 13
SABCS 2022 Takeaways - 14
SABCS 2022 Takeaways - 15
SABCS 2022 Takeaways - 16
SABCS 2022 Takeaways - 17
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