HR+ BC: Is There Still a Role for Everolimus Post–Endocrine Therapy?

EP: 1.Frontline Treatment Strategies for HR+/HER2- Breast Cancer

EP: 2.CKD4/6 Inhibition in HR+/HER2- BC: Trial Data With Abemaciclib and Ribociclib

EP: 3.CKD4/6 Inhibition in HR+/HER2- BC: Trial Data With Palbociclib

EP: 4.HR+/HER2- BC: Selecting a CDK4/6 Inhibitor in the Frontline Setting

EP: 5.HR+/HER2- Breast Cancer: Identifying Barriers to Use of CDK4/6 Inhibition

EP: 6.Real-World Use of CDK4/6 Inhibition in HR+/HER2- Breast Cancer

EP: 7.Frontline Combination Strategies in HR+/HER2- BC

EP: 8.Is There a Role for CDK4/6 Inhibition in HR+/HER2+ Breast Cancer?

EP: 9.Novel Treatment Approaches to Relapsed/Refractory HR+ Breast Cancer

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EP: 10.HR+ BC: Is There Still a Role for Everolimus Post–Endocrine Therapy?

EP: 11.Novel Therapy for Relapsed/Refractory HR+ BC: Oral SERDs

EP: 12.Novel Therapy for Relapsed/Refractory HR+ BC: PI3K Inhibitors

EP: 13.Second-Line Use of CDK4/6 Inhibitors in HR+ Breast Cancer

EP: 14.ADCs in HR+/HER2- Advanced BC: Results From TROPICS-02 and DESTINY-Breast04

EP: 15.Considerations for Use of ADCs in HER2-Low Breast Cancer

EP: 16.Novel Therapy for Relapsed/Refractory HR+ BC: IO Therapy and PARP Inhibition

EP: 17.Optimizing Management of HR+/HER2- BC: Future Directions in Care

Transcript:

Hope S. Rugo, MD, FASCO: We don’t want to abandon our older drugs, right? I’m going to ask you 2 things. One, is there still a role for everolimus and how would you put that into your sort of schema, sequencing of treatment? And two, what do you think about the SERDs [selective estrogen receptor downregulators]? You heard about the update subsets in the EMERALD, and then 2 trials which haven’t been reported publicly have press releases saying they weren’t better than the treatment of physician choice endocrine therapy.

Anne O’Dea, MD: The first question about everolimus—it’s certainly a tool in our arsenal; it’s something that we need to remember for selected patients who for whatever reason maybe haven’t tolerated CDK4/6 or some other endocrine therapies. It’s hard to imagine now if we look at time to progression post CDK4/6 with everolimus, it’s really not very good. Therefore, it’s hard to imagine a scenario in the era of PIK3CA inhibitors and the era of antibody drug conjugates for HER2 low also in this space. It’s very hard to imagine a very large use for everolimus, although certainly I have patients who really prefer being on that oral agent for whatever reason and want to give an oral-targeted agent 1 more try before they move forward into potential intravenous therapeutic options.

Hope S. Rugo, MD, FASCO: A lot of the trials actually that are being planned, including trials with elacestrant, will have arms combined with everolimus. Elacestrant, giredestrant [ph] has one. I know Avera [ph], it’s called? There are some others, too, who don’t have a PIK3CA mutation, right? Are you still using everolimus in clinical practice?

Mark Pegram, MD: Of course, yes, at least in 2022. That’s another line of endocrine therapy. They can install the need for cytotoxic chemotherapy and its associated [adverse] effects. I wonder what’s going to happen in the ADC [antibody-drug conjugates] era. The ADC trials, though, are patient populations that have had some prior chemo already; it probably can’t replace another line of hormone therapy.

Hope S. Rugo, MD, FASCO: They’re generally better tolerated, yes. Although for some, maybe not. I don’t know for sure.

Transcript edited for clarity.