ASCO breast cancer update 2024.
Neil Love interviews Priyanka Sharma, Univ of Kansas
1. Low serum picoAMH (<10) is a predictor of adjust chemo benefit, 21% of premenopausal <55 y/o has AMH in postmenopausal range
2. RSClinN+ (1-3 LNs) tool provided more prognostic info more than RS alone, pre vs. post menopausal differs
3. ctDNA in monarchE study, 8% positive at baseline, not much conclusive info
4. Inovo120: high risk, met on adjuvant AI<12m, triple therapy, backbone fulvestrant+palbo, PFS2 HR 0.54, d/c due to AE 6.2%
5. postMonarch study: abeam + fulvastrant vs. Fulvastrant alone (progression on prior AI+CDKi, >12m on prior AI is a response predictor. Use this option, when not eligible for PIK3K/AKT inhibitors
6. Tropion-breast01, HR+/Her2 0/1/2, prior 1-2 lines of chemo, Dato-Dxd beats ICC, PFS HR: 0.63, likely get FDA approval
7. Destiny-breast06, T-Dxd first-line, including her2-low and ultralow (membrane stain <10%), high risk population, PFS HR 0.63, ORR 57.3%
8. Saci TMT, phase III in TNBC, HR 0.32, OS is better, heme, ILD 0.8%, stomatitis 44%, pending FDA approval
9. earlier phase studies, EMBER, I-SPY 2.2, IO in TNBC post-neoadjuvant, Olaparib phase II study