Breast Cancer

Panelists discuss how implementing in-house biomarker testing can significantly enhance patient care through faster turnaround times and streamlined decision-making processes. This approach reduces dependence on external laboratories while enabling more immediate clinical interventions. Key implementation considerations include staff expertise, quality control protocols, equipment costs, regulatory compliance, and testing volume to ensure operational efficiency and return on investment

Panelists discuss how clinical trials like DESTINY-Breast04, TROPiCS-02, and TROPION-Breast01 have revolutionized treatment options for HER2-low advanced breast cancer by validating novel targeted therapies and antibody-drug conjugates.

David Rimm, MD, PhD, discusses pathology limitations that have been exacerbated by the current lineup of breast cancer IHC tests.

Jian Zhang, MD, discusses SIM0270, a brain-penetrant oral SERD, in combination with everolimus, in ER-positive, HER2-negative advanced breast cancer.

Panelists discuss how first- and second-line treatment options for HR+ advanced/metastatic breast cancer, particularly the use of CDK4/6 inhibitors (CDK4/6i) in combination with endocrine therapy, are influenced by clinical factors such as bone metastasis, visceral crisis, and molecular phenotype, while also reviewing the latest clinical trial data, real-world outcomes, and comparative efficacy of ribociclib, abemaciclib, and palbociclib.

The FDA has granted a breakthrough device designation to the DCISionRT test for patients with breast cancer with ductal carcinoma in situ.

Panelists discuss how in-house comprehensive genomic profiling (CGP) testing offers key benefits like reduced turnaround times, direct control over processes, and immediate access to testing resources. However, significant challenges include substantial initial capital investment, the need for specialized staff recruitment and retention, and ongoing equipment maintenance requirements. Health care facilities must carefully weigh these trade-offs, considering their patient volume, existing infrastructure, and financial capabilities before implementing in-house CGP services.

Panelists discuss how centralized biomarker testing outsources analysis to specialized laboratories while decentralized testing occurs in-house. In-house testing offers tighter workflow control and closer pathology collaboration but requires more resources, whereas send-out testing leverages external expertise.

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The FDA approved datopotamab deruxtecan for select unresectable or metastatic, hormone receptor–positive, HER2-negative breast cancer.

Panelists discuss how comprehensive genomic testing may not be practical for well-understood tumors with established treatment pathways. Narrow panel testing is preferred when specific mutations guide therapy (like EGFR in lung cancer) or when time/cost constraints exist.

Panelists discuss how comprehensive biomarker testing enables detection of actionable mutations across cancer types, informing targeted therapy selection. This broad molecular profiling approach can reveal treatment opportunities regardless of tumor origin.

Katherine L. Nathanson, MD, discusses the identification of reversion mutations in BRCA1/2 in response to therapy among patients with breast cancer.

Stephanie L. Graff, MD, FACP, FASCO, discusses current strategies for fertility preservation in patients with breast cancer.

Stephanie L. Graff, MD, FACP, FASCO, discusses data supporting the use of GnRH agonists for premenopausal women with breast cancer undergoing chemotherapy.

Panelists discuss how evolving HER2 classification methods and recent trial data are reshaping treatment approaches for advanced breast cancer, particularly regarding the clinical significance of HER2-low and ultralow categories.

Panelists discuss how the latest NCCN guidelines for targeted therapies and biomarker testing in advanced/metastatic breast cancer highlight the importance of biomarker-driven approaches, with particular emphasis on the need for next-generation sequencing testing in the first-line setting, the implications of HER2-low classification, and how the recent FDA approval of a PI3K inhibitor may impact testing practices and treatment strategies.

Erica L. Mayer, MD, MPH, responses with preoperative niraparib plus dostarlimab in patients with BRCA-mutant, ER-positive, HER2-negative breast cancer.

Laura A. Huppert, MD, discusses survival outcomes of patients with metastatic breast cancer and leptomeningeal disease according to disease subtype.

Charles E. Geyer, Jr., MD, discusses the efficacy and safety of perioperative atezolizumab plus chemotherapy in stage II/III triple-negative breast cancer.

Alexis LeVee, MD, discusses immune-related adverse effects in patients with early breast cancer treated with immune checkpoint inhibitors.

A childhood dream became a reality for Montana native Kelly K. Hunt, MD, FACS, FSSO, who has changed the face of the surgical breast oncology workforce.

Panelists discuss how adjuvant therapy in HR+/HER2- early-stage breast cancer is influenced by key risk factors, with a focus on recent studies involving CDK4/6 inhibitors like abemaciclib, ribociclib, and palbociclib, and how these treatments are shaping the adjuvant treatment strategy based on efficacy data from trials such as MonarchE, NATALEE, and PALLAS.

Drs Park and Curigliano discuss the DESTINY-Breast06 trial of T-DXd in patients with HER2-low or -ultralow, HR–positive, metastatic breast cancer.

Experts detail how recent NCCN guideline changes in dozens of tumor types are affecting their practices, and we gather all the NCCN updates in a slideshow.