Dr Bhave on the Impact of New Treatment Strategies on the Landscape of HR+/HER2– Breast Cancer

Manali Bhave, MD, medical oncologist, Winship Cancer Institute, an assistant professor, the Department of Hematology and Medical Oncology, Emory University School of Medicine, discusses the impact of new treatment strategies on the landscape of hormone receptor (HR)–positive/HER2-negative breast cancer.

At a recent OncLive® State of the Science Summit™, Bhave demonstrated how newer data has been integrated into approaches that already exist within the treatment landscape of patients with advanced HR-positive/HER2-negative or HER2-low breast cancer. A key takeaway from the case data presentation revolved around the sequencing of endocrine therapies, Bhave begins. When patients become refractory to endocrine therapy, sequencing decisions must be made for antibody-drug conjugates that are emerging in the treatment space for patients with advanced HR-positive breast cancer, Bhave expands.

Furthermore, based on the data that was discussed at the OncLive® State of the Science Summit™ by Kevin Kalinsky, MD, MS, of Winship Cancer Institute, CDK4/6 inhibitors have an established role within the HR-positive breast cancer space, Bhave explains. Frontline CDK4/6 inhibitors and endocrine therapy typically provide the most benefit for this patient population, including those with visceral metastases, Bhave notes. Following disease progression after frontline treatment, newer data within the landscape become applicable, Bhave adds.

For example, the January 2023 FDA approval of elacestrant (Orserdu) for patients with estrogen receptor–positive, HER2-negative, ESR1-mutated breast cancer who have progressed on a minimum of 1 line of endocrine therapy. This agent has added a promising treatment approach to the landscape. However, patients in this setting have some other standard-of-care options available, including fulvestrant (Faslodex) in combination strategies with everolimus, an mTOR inhibitor, or another aromatase inhibitor, Bhave continues. With these advances in the field, Bhave concludes.