Sara M. Tolaney, MD, MPH

Sara M. Tolaney, MD, MPH, associate director of the Susan F. Smith Center for Women’s Cancers; director of Clinical Trials, Breast Oncology; and senior physician at Dana-Farber Cancer Institute, and assistant professor of medicine at Harvard Medical School, discusses where she sees the treatment landscape evolving in the future for patients with hormone receptor (HR)-positive metastatic breast cancer.

There have been many advancements over the last several years for the treatment of patients with HR-positive metastatic breast cancer, but Tolaney believes there will be a shift towards combination therapy in the future. Current treatment options in the include the combination of endocrine therapy with CDK4/6 inhibition, while physicians may also consider mTOR or PI3K inhibition with endocrine therapy.

In terms of moving forward, Tolaney says 1 major consideration will be combination strategy, which is under exploration in several clinical trials today. These studies are aiming to move the use of CDK4/6 inhibition forward, as well as treatments in the adjuvant setting and treatment with mTOR and PI3K inhibitors as partners for combination strategies. Tolaney says there are many options and new directions for replacing endocrine therapy backbones and perhaps moving into the earlier disease settings. However, first robust data from monotherapy trials are needed.

Videos

Sara M. Tolaney, MD, MPH, discusses where she sees the treatment landscape evolving in the future for the treatment of patients with hormone receptor-positive metastatic breast cancer.

Combination Strategy May Play Role in Treatment of HR+ Metastatic Breast Cancer

HER2 Assessment in Breast Cancer

Neoadjuvant Approaches for Early-Stage HER2+ Breast Cancers

HER2 Heterogeneity and Neoadjuvant Therapy in Breast Cancer

Neoadjuvant T-DM1 in Early-Stage HER2+ Breast Cancer

The APHINITY Trial in Early-Stage HER2+ Breast Cancer

Adjuvant T-DM1 Therapy for Early-Stage HER2+ Breast Cancer

The ExteNET Study & Management of HER2+ Breast Cancer

Novel Approaches for Stage I HER2+ Breast Cancer

Sara M. Tolaney, MD, MPH, discusses newer approaches to managing early stages of HER2+ breast cancer in both the neoadjuvant and adjuvant spaces.

Update on HER2-Targeted Therapy in Early Breast Cancer

Sara M. Tolaney, MD, MPH, discusses the results of the monarcHER trial, which examined adding the CDK4/6 inhibitor abemaciclib and endocrine therapy to trastuzumab versus trastuzumab plus chemotherapy in advanced hormone receptor-positive, HER2-positive breast cancer.

The monarcHER Trial in Advanced HR+, HER2+ Breast Cancer

Sara M. Tolaney, MD, MPH, Dana-Farber Cancer Institute, discusses the evolving role of neoadjuvant endocrine therapy in the breast cancer space. She says there is particular interest in using this therapy in patients with HER2-positive and triple-negative breast cancer, but it can be more challenging in patients with ER-positive disease.

Using the responses of preoperative therapy can help physicians adapt adjuvant therapy regimens and improve responses in patients, Tolaney says. However, patients with ER+ disease do not achieve pathologic complete responses as often in this setting. The development of surrogate biomarkers helps in learning how to use neoadjuvant endocrine therapy.

Neoadjuvant endocrine therapy has been associated with improved rates of breast conservation. This therapy is also less toxic than neoadjuvant chemotherapy. The biggest challenge with this therapy is selecting which patients will benefit better from the endocrine therapy versus chemotherapy, says Tolaney.

Sara M. Tolaney, MD, MPH, discusses the evolving role of neoadjuvant endocrine therapy in the breast cancer space. She says there is particular interest in using this therapy in patients with HER2-positive and triple-negative breast cancer, but it can be more challenging in patients with ER-positive disease.

Sara M. Tolaney, MD, MPH | Authors

Articles

Combination Strategy May Play Role in Treatment of HR+ Metastatic Breast Cancer

Update on HER2-Targeted Therapy in Early Breast Cancer

The monarcHER Trial in Advanced HR+, HER2+ Breast Cancer

Evaluating the Role of Neoadjuvant Endocrine Therapy in Breast Cancer