Virginia G. Kaklamani, MD, DSc

Virginia Kaklamani, MD, DSc, discusses inavolisib's efficacy in PIK3CA-mutated metastatic breast cancer, as well as the importance of biomarker testing.

Virginia Kaklamani, MD, DSc, discusses the mechanism of action of inavolisib and the importance of the addition of this agent to the HR-positive metastatic breast cancer treatment paradigm.

Virginia Kaklamani, MD, DSc, discusses an analysis of ESR1 allelic frequencies in elacestrant-exposed ER+/HER2– metastatic ESR1-mutated breast cancer.

Virginia Kaklamani, MD, discusses the optimal role for adjuvant ribociclib alongside endocrine therapy in early-stage HR+/HER2– breast cancer.

In their concluding remarks, Virginia Kaklamani, MD, DSc, and Heather McArthur, MD, summarize their key insights and perspectives on the management of HR+ breast cancer.

The key opinion leaders discuss the current unmet needs in the management of HR+/HER2- metastatic breast cancer and explore potential future directions and strategies that may lead to improved patient outcomes.

In their discussion, the key opinion leaders explore the potential of combination therapies in HR+/HER2- metastatic breast cancer, with a specific focus on the ELECTRA study, which investigated the combination of elacestrant and abemaciclib.

The expert panel examines the subgroup data from the postMONARCH study, focusing on patients with ESR1 and PIK3CA mutations, and emphasizes the important role of CDK4/6 inhibitors in the treatment of these specific patient populations with HR+/HER2- metastatic breast cancer.

In their discussion, the key opinion leaders explore the significance of PIK3CA mutations in HR+/HER2- metastatic breast cancer and review the findings from two pivotal clinical trials, SOLAR-1 and CAPItello-291, which investigated the efficacy of targeted therapies in patients harboring these mutations.

Virginia Kaklamani, MD, DSc, and Heather McArthur, MD, discuss the clinical presentation and management of a 64-year-old postmenopausal female with a history of rheumatoid arthritis who was diagnosed with stage IV, grade 3, invasive ductal carcinoma in her left breast, taking into account her comorbidities and the advanced stage of her breast cancer.

The breast cancer experts share their clinical experiences and strategies regarding the optimal timing for testing ESR1 mutations in patients with HR+/HER2- metastatic breast cancer, elaborating on how the specific points in the treatment journey at which they recommend testing influence their subsequent treatment decisions and overall approach to patient management.

Key opinion leaders examine the EMERALD trial, which evaluates the efficacy of elacestrant in patients with HR+ HER2- metastatic breast cancer, focusing on the subgroup analysis of patients with visceral metastases, and explore how the trial's design and results have influenced their clinical practice.

Virginia Kaklamani, MD, DSc, and Heather McArthur, MD, present a patient case involving a 54-year-old postmenopausal woman diagnosed with a 2.1cm estrogen receptor positive (ER+), HER2 negative breast cancer, and discuss the clinical implications and management strategies for this specific patient scenario.

In their discussion, medical experts in the field of breast cancer explore the role of liquid biopsies and compare the significance of ESR1 mutations to other biomarkers, such as PIK3CA, in terms of their driver versus passenger status in the context of HR+/HER2- breast cancer.

The key opinion leaders (KOLs) review the current testing methods for detecting ESR1 mutations and explore the existing strategies employed to overcome or delay the development of these mutations and the associated endocrine resistance in patients with HR+/HER2- metastatic breast cancer.

Virginia Kaklamani, MD, DSc, and Heather McArthur, MD, explore the clinical significance of *ESR1* mutations in HR+/HER2- metastatic breast cancer patients, including their impact on disease prognosis, treatment outcomes, and the increasing prevalence of these mutations with each line of endocrine therapy, ultimately informing their therapeutic approach.

Panelists wrap up their discussion on HER2+ breast cancer by summarizing the most exciting recent advances in the field and their hopes for the future of treatment.

Dr Kaklamani presents a profile of a patient with HER2+ breast cancer and liver metastases who had disease progression after first-line chemotherapy and a solitary new brain metastasis after second-line T-DM1.

Melinda L. Telli, MD, presents a profile of a patient with early stage breast cancer with residual nodal disease after neoadjuvant chemotherapy and surgery, whose tumor was initially HER2+ but became triple-negative after treatment.

Virginia G. Kaklamani, MD, DSc, presents a patient profile of early stage HER2+ breast cancer with residual nodal disease after neoadjuvant chemotherapy and surgery.

Experts share their go-to regimens in the third-line and higher setting of HER2+ metastatic breast cancer, and touch on the factors that support their decision-making.

Debu Tripathy, MD, discusses novel therapies being developed for later-line treatment of HER2+ mBC.

Drs McArthur and Telli discuss recent data updates from the DESTINY-Breast trials of T-DXd, including a pooled analysis, and share best practices for monitoring patients for lung complications.

Drs Tripathy and Kaklamani emphasize the most critical unmet needs for patients with HER2+ metastatic breast cancer in the third-line or higher settings and recap what the field previously learned from the HER2CLIMB trial of tucatinib/trastuzumab/capecitabine.

Panelists briefly touch on ongoing trials of second-line tucatinib combination therapy, including HER2CLIMB-02 and HER2CLIMB-05, in patients with or without brain metastases, and offer their clinical perspective which second-line regimens they typically recommend for their patients with HER2+ mBC.

Experts introduce the antibody-drug conjugates (ADCs) trastuzumab emtansine (T-DM1) and trastuzumab deruxtecan (T-DXd) and discuss clinical trial findings and potential use in special patient populations, such as those with brain metastases.

Drs McArthur and Kaklamani expand upon the standard-of care regimens used for first-line treatment of patients with HER2+ metastatic breast cancer (mBC), review clinical data supporting their use, and share excitement for upcoming data readouts on novel regimens in the space.

Closing out their discussion on fertility preservation in breast cancer, Matteo Lambertini, MD, PhD, and Virginia Kaklamani, MD, DSc, look toward unmet needs and future evolutions in the treatment landscape and offer advice for community physicians.

Expert oncologists Matteo Lambertini, MD, PhD, and Virginia Kaklamani, MD, DSc, review fertility preservation strategies in the context of patients with breast cancer undergoing surgery.

Panelists discuss recent data updates on standard-of-care and emerging regimens for adjuvant treatment of HER2+ eBC, including data presented at the 2023 ASCO meeting, and highlight exciting trials in progress that have not yet read out.