The 2024 San Antonio Breast Cancer Symposium (SABCS) highlighted groundbreaking research and treatment innovations, offering new insights into breast cancer management. The symposium, one of the largest and most influential events in the field, drew thousands of delegates worldwide to discuss the latest clinical trials and research advancements.
PATINA Trial: A Potential New Standard of Care
Researchers presented findings from the PATINA clinical trial, suggesting a potential shift in the standard of care for patients with hormone receptor-positive (HR+) and HER2-positive metastatic breast cancer. The trial investigated the addition of palbociclib to anti-HER2 treatment (trastuzumab and pertuzumab) and endocrine therapy in women who had previously received chemotherapy, trastuzumab, and pertuzumab. The results indicated that adding palbociclib significantly improved progression-free survival by 15.2 months compared to standard treatment alone. According to Sara Hurvitz, MD, from Fred Hutch Cancer Center, the median PFS in the palbociclib arm is "incredible and historic".
COMET Trial: Active Monitoring as a Viable Option for DCIS
The COMET trial explored the management of ductal carcinoma in situ (DCIS), a non-invasive condition where abnormal cells are found in the milk ducts. The primary analysis revealed that active monitoring in patients with low-risk DCIS was comparable to upfront surgery. Patients undergoing active monitoring reported similar physical, emotional, and psychological outcomes to those receiving immediate treatment. These findings suggest that active monitoring could be a reasonable approach for women with low-risk DCIS, potentially reducing the need for immediate surgical intervention. Longer-term follow-up data is expected to provide further insights.
OlympiA Trial: Long-Term Benefits of Olaparib
Ten-year results from the OlympiA clinical trial demonstrated the long-term efficacy of olaparib in preventing cancer recurrence. The study, which began a decade ago, showed that adding olaparib to standard treatment reduced the risk of cancer recurrence by 35% and the risk of death by 28%. After six years, 87.5% of patients treated with olaparib were still alive, compared to 83.2% of those given a placebo. These findings reinforce the importance of BRCA testing at cancer diagnosis to identify patients who may benefit from olaparib treatment. The trial included 1,836 patients worldwide, including 60 women from 12 participating institutions in Australia.
DECRESCENDO Trial: Shorter Chemotherapy Duration
The DECRESCENDO trial investigated whether a shorter duration of chemotherapy with trastuzumab and pertuzumab before surgery could yield similar outcomes to more intensive treatment for HER2-positive early breast cancer. The findings reported a very high 86% complete clearance of cancer cells by the time of surgery, suggesting that a less intense treatment regimen may be sufficient for some patients.
SUPREMO Trial: Re-evaluating Radiotherapy After Mastectomy
The SUPREMO trial aimed to determine if some patients could safely avoid chest wall radiotherapy after mastectomy without compromising long-term outcomes. The trial found equivalent overall survival in both groups, with and without radiotherapy, suggesting that selected patients with a low axillary nodal burden can safely avoid radiotherapy after mastectomy.
EBCTCG Obesity Overview: BMI Impact on Breast Cancer
An analysis by the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) of data from 206,904 women with early breast cancer found that elevated BMI increases the risk of breast cancer mortality and recurrence. The research indicated an increased risk regardless of age, tumor type, year of diagnosis, and hormone receptor status, suggesting the need for future studies exploring weight loss interventions to reduce recurrence and mortality risks.
The Lancet Breast Cancer Commission Report
The Lancet Breast Cancer Commission Report provided a critical update on breast cancer, highlighting urgent challenges and inequalities worldwide. The report emphasized six key themes: prevention, personalization, inclusion, collaboration, identification, and communication, offering a roadmap for addressing these challenges.
EMBER-3 Trial: Imlunestrant Efficacy
EMBER-3 offered data on the efficacy of a new endocrine therapy, a selective estrogen receptor degrader (SERD) known as imlunestrant. In the combination arm (imlunestant/abemaciclib) versus imlunestrant alone, there was a significantly improved mPFS of 9.4 months vs 5.5 months (HR 0.57; p<0.001).
