William J. Gradishar, MD, discusses the most recent evolutions in the management of patients with advanced breast cancer.
William J. Gradishar, MD, professor of medicine of hematology and oncology, Betsy Bramsen Professor of Breast Oncology, and chief of hematology and oncology in the Department of Medicine at the Feinberg School of Medicine at Northwestern University, discusses the most recent evolutions in the management of patients with advanced breast cancer.
In the breast cancer space, new data has led to update disease management recommendations. The subgroup of patients which have seen the most recent changes in guidelines is those with estrogen receptor (ER)-positive disease.
Where there was once only endocrine therapy alone, various options now exist for the management of this patient population, including CDK4/6 inhibitors like abemaciclib (Verzenio) or PARP inhibitors like olaparib (Lynparza).
Gradishar notes that the use of checkpoint inhibitors as a treatment for patients at a higher risk with early-stage breast cancer is also gaining traction. Giving checkpoint inhibitor therapy in addition to chemotherapy has been validated and further enhances risk reduction in regard to pathological complete response (pCR) and recurrent events.
0:08 | The other area that I think is evolving is the use of checkpoint inhibitors as a treatment for early-stage breast cancer for patients at higher risk. Those are patients where we would typically be giving neoadjuvant therapy and those are patients with triple negative disease, usually with bigger tumors or no positive disease.
0:32 | We learned from the trials with pembrolizumab that giving chemotherapy with the addition of pembrolizumab not only increases the pCR rate, the number of patients without evidence of disease in their breast at the time of surgery, but when you go downstream and follow these patients out, there are fewer of them that will develop a recurrence. It's been validated that giving checkpoint inhibitor therapy with chemotherapy preoperatively does further enhance risk reduction, not only in terms of pCR, but recurrence events.