Breast Cancer

Aditya Bardia, MD, MPH, FASCO, discusses the FDA approval of Dato-DXd for pretreated, hormone receptor–positive, HER2-negative metastatic breast cancer.

Coauthor of the Lancet Breast Cancer Commission report, Reshma Jagsi, MD, DPhil, details the 6 themes of the evidence-based plan aimed to address challenges in the field.

Panelists discuss how in-house laboratory testing has demonstrated significant advantages in patient care through rapid turnaround times and immediate decision-making capabilities. Emergency departments have seen notably improved outcomes when critical tests like cardiac markers and blood gases are performed on-site, enabling faster treatment initiation for acute conditions. For example, rapid troponin testing in-house allows for immediate cardiac intervention decisions, while stat electrolyte panels enable quick medication adjustments for critical patients. Additionally, on-site therapeutic drug monitoring helps clinicians make real-time dosing modifications, which is particularly beneficial for antibiotics and anticoagulation therapy.

Panelists discuss how in-house testing facilities significantly enhance multidisciplinary coordination by enabling rapid result turnaround and real-time treatment adjustments. This streamlined process facilitates immediate care planning among specialists, leading to faster clinical decisions and reduced wait times. Studies demonstrate that on-site testing correlates with improved patient outcomes through earlier interventions, decreased length of stay, and enhanced treatment monitoring, ultimately supporting more efficient and responsive patient care delivery.

T-DXd wins FDA approval in HER2-low and -ultralow breast cancer, 177 Lutetium edotreotide boosts PFS in GEP-NETS, and more from OncLive this week.

Datopotamab deruxtecan approaches approval in Europe as an option for patients with previously treated hormone receptor–positive breast cancer.

OQY-3258 (ESG401) showed preliminary efficacy in multiple breast cancer subtypes, including TNBC and HR+/HER2- breast cancer.

Panelists discuss how emerging data on HER2-ultralow breast cancer is informing treatment decisions, particularly regarding the potential role of trastuzumab deruxtecan, while acknowledging the need for careful patient selection and consideration of traditional treatment sequences.

Panelists discuss how DESTINY-Breast06 demonstrated meaningful clinical activity of trastuzumab deruxtecan in both HER2-low and ultralow metastatic breast cancer populations.

Inavolisib plus palbociclib/fulvestrant improved OS vs palbociclib/fulvestrant alone in PIK3CA-mutated, HR-positive, HER2-negative, advanced breast cancer.

Panelists discuss their overall perceptions of oral selective estrogen receptor degraders (SERDs) and their impact on the treatment landscape and share their experiences with elacestrant in clinical practice.

Panelists discuss potential treatment options for patients following progression on CDK4/6 inhibitors (i) in HR+/HER2– metastatic breast cancer.

Panelists discuss how in-house testing significantly reduces turnaround times by eliminating send-out delays and courier dependencies. This enables immediate sample processing, allowing for faster results delivery and prompt clinical decision-making. Health care facilities can optimize workflows through automated systems, clear communication protocols, and standardized testing procedures, minimizing bottlenecks between departments and facilitating quicker diagnosis and treatment initiation.

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.

Sotorasib doublet gets approved for KRAS G12C–mutated CRC, acalabrutinib triplet is cleared for previously untreated MCL, and more from OncLive.

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.