“Triple-negative breast cancer remains the most challenging subtype to treat because of its aggressive phenotype and limited treatment options,” stated Erica Michelle Stringer-Reasor, MD, who spoke at an education session on current approaches to treatment and future directions during the 2023 ASCO Annual Meeting.

The addition of the CDK4/6 inhibitor ribociclib to endocrine therapy significantly improved invasive disease–free survival in women with hormone receptor–positive, HER2-negative, early-stage breast cancer. These results of the phase III NATALEE trial were reported by lead author Dennis J. Slamon, MD, PhD, Director of Clinical/Translational Research and Director of the Revlon/UCLA Women’s Cancer Research Program at the UCLA Jonsson Comprehensive Cancer Center, at the 2023 ASCO Annual Meeting.¹ Of note, NATALEE included patients with node-negative and node-positive, early-stage breast cancer, unlike other recent trials in the adjuvant setting.

A meta-analysis of randomized trials has revealed a benefit to ovarian ablation or suppression in preventing breast cancer recurrence in premenopausal women with estrogen receptor–positive tumors. The findings, based on almost 15,000 women in studies spanning several decades, were discussed at the 2023 ASCO Annual Meeting by Richard G. Gray, MA, MSc, who presented the study on behalf of the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG).

The phase II PHERGain trial, which employed a response-adapted strategy in the treatment of early-stage, HER2-positive breast cancer, has shown promising results for the selective use of HER2 blockade and de-escalation of chemotherapy. Nearly all patients assigned to skip chemotherapy prior to surgery for early-stage, HER2-positive breast cancer were without a recurrence at 3 years. The noncomparative randomized study, whose results were reported at the 2023 ASCO Annual Meeting, used a response-adapted design to identify early responders by fluorine-18–fluorodeoxyglucose (F-18–FDG)–positron-emission tomography (PET) and pathologic complete responders after neoadjuvant therapy who might be effectively treated with trastuzumab and pertuzumab, minus the standard chemotherapy.

Additional follow-up of the phase III TROPiCS-02 trial has upheld the progression-free and overall survival benefit seen with sacituzumab govitecan-hziy compared with physician’s choice of treatment in patients with endocrine-resistant, hormone receptor–positive, HER2-negative metastatic breast cancer. Sacituzumab govitecan reduced the risk of disease progression or death by 35% and the risk of death by 21%, according to Sara M. Tolaney, MD, MPH, Associate Professor of Medicine at Harvard Medical School and Chief of the Division of Breast Oncology at Dana-Farber Cancer Institute, who presented the findings at the 2023 ASCO Annual Meeting.

Recent improvements in overall and progression-free survival for patients with HER2-positive and estrogen receptor–positive breast cancers have not come at the expense of quality of life or symptom management, according to a pair of studies presented at the European Society for Medical Oncology (ESMO) Breast Cancer Congress 2023.