Highlights from Gather Session: Early Breast Cancer (EBC) and Metastatic Breast Cancer (MBC)
Breast Cancer Connect recently hosted a Q&A session with Oncologists regarding the treatment of Early Breast Cancer (EBC) and Metastatic Breast Cancer (MBC)
Below are some highlights from the discussion:
Respondents found abemaciclib promising in high-risk EBC patients; however, some wanted to see more data.
- “It is a good option for high-risk patients as defined by the MONARCH-E study- either N2 status with 4 or more LN +ve; or N1 (3 or less LN+ve with either one other feature - grade 3, Ki 67 of 20 or more or tumor size > or = 5cm, who are wanting to do everything within the current treatment scope to avoid recurrence.”
- “Disease free survival is only a surrogate for overall survival, which will take years to determine in an adjuvant trial. Question not yet addressed, are we delaying or preventing recurrence? Do we know for sure that we are improving survival in these very high-risk patients?”
Respondents were split on whether they share data from monarchE trial with their EBC patients.
- “I do share relative and absolute risk reductions from MONARCHE.”
- “I generally do not quote concrete numbers.”
- “I discuss results of monarch e broadly with rounded figures.”
Most respondents recognized the importance of Ki-67 scoring as a therapeutic biomarker for EBC and noted that it was routinely performed at their institutions.
- “I do feel that Ki 67 is a very important prognostic biomarker. Ki 67 higher than 20 portrays a more aggressive the tumor.”
- “I agree with using Ki67, which is routinely reported in path reports now.”
Respondents note support of the use of fulvestrant and abemaciclib for hormone-receptor-positive, HER2-negative metastatic or advanced-stage breast cancer in cases where cancer growth persisted following hormonal therapy treatment. Many cited strong clinical-trial data. Nevertheless, various clinicians had limited experience with this indication.
- “Monarch -2 showed more than doubling of ORR with this combination compared to fulvestrant alone, and I recommend it for my patients who missed receiving cdk-4/6 inhibitors in front line metastatic setting.”
- “Fulvestrant/Abemaciclib is very effective and well tolerated, but I would say the same about Fulvestrant/Palbociclib and do not have experience with Ribociclib but expect it would be the same. I use this for women with recurrence on adjuvant AI or in < 12 months from end of adjuvant AI.”
Most respondents have limited or no experience with abemaciclib monotherapy to treat hormone-receptor-positive, HER2-negative metastatic or advanced-stage breast cancer in cases of cancer growth following hormonal therapy treatment, as well as earlier chemotherapy due to metastases.
- “I have not used Abema on its own. I try to combine in with an AI or fulvestrant. The fact that it has single agent activity is a selling point that I use when talking to patients on the risk benefits of Adjuvant Abema.”
- “I have not, I have always combined it with ET [endocrine therapy].” You can add to the conversation regarding treatment of Early Breast Cancer (EBC) and Metastatic Breast Cancer (MBC) by commenting below:
