2024-SABCS-Takeaways - 4

MEDICAL ONCOLOGY CONTINUED
Research Roundup
Read on for key takeaways about studies featured in
presentations at the 2024 SABCS®. For more details, click on
the linked trial names. Session recordings will be available on
demand for registered attendees through March 31, 2025.
Triple-negative breast cancer
(TNBC) remains a therapeutic
challenge. The KEYNOTE-522
regimen with neoadjuvant
pembrolizumab has become
standard of care, but questions
remain about atezolizumab
and other immune checkpoint
inhibitors. An exploratory analysis
of KEYNOTE-522 (LB1-07) found
that several biomarkers (including
T cell-inflamed gene expression
profile) were positively prognostic
for pathologic complete response
(pCR) and/or event-free survival
(EFS), but were not predictive of
benefit from pembrolizumab.
NSABP B-59/GBG-96GeparDouze
(GS3-05) compared
neoadjuvant atezolizumab
plus chemotherapy followed
by adjuvant atezolizumab
plus chemotherapy versus
chemotherapy alone for patients
with stage II/III TNBC. There was
no significant difference in EFS or
overall survival (OS), but numerical
improvements for atezolizumab
suggested additional studies for
potential biomarkers to identify
subpopulations that might benefit.
For those patients with high
genomic risk, node-negative,
4
hormone receptor (HR)-positive,
human epidermal growth factor
receptor 2 (HER2)-negative breast
cancer, a post-hoc analysis of
TAILORx (GS3-03) examined
the impact of anthracyclines
in early-stage disease. Adding
an anthracycline to taxanebased
chemotherapy showed a
significant benefit in estimates of
distant recurrence-free interval
(DRFI), distant recurrence-free
survival (DRFS), recurrence-free
interval (RFI), and recurrencefree
survival (RFS), with a trend
toward OS benefit, compared
with chemotherapy alone. The
benefit was significant only when
controlling for clinicopathologic
factors such as tumor size,
patient age, and recurrence score.
Anthracycline benefit was seen
primarily in larger tumors and
for patients with higher
recurrence scores.
A separate real-world analysis of
patients with HR-positive, HER2negative
disease suggested that
MammaPrint and BluePrint assays
may also predict sensitivity to
neoadjuvant chemotherapy. The
FLEX trial (PS4-04) found that
patients with a MammaPrint risk
score of High 2 (H2) are more
likely to have a partial response or
a pathologic complete response
to neoadjuvant chemotherapy
- even those with luminal B and
basal subtypes - than patients
with low risk and H1 scores.
PADMA (LB1-03) was the first
prospective phase IV trial to
compare guideline-concurrent
CDK4/6 inhibitor (palbociclib) plus
endocrine therapy (ET) to monochemotherapy
plus ET in patients
with high-risk metastatic breast
cancer. The results support existing
international guidelines favoring
a CDK4/6 inhibitor plus ET as the
standard first-line treatment for
patients with HR-positive, HER2negative
metastatic breast cancer.
Long-term follow-up data from
the OlympiA trial (GS1-09) of
adjuvant olaparib for patients with
germline BRCA1/2 mutations and
HER2-negative primary breast
cancer confirmed earlier results.
Adjuvant olaparib significantly
improved OS and both of the study's
endpoints - invasive disease-free
survival (IDFS), and distant diseasefree
survival (DDFS) - compared
with placebo at 6.1 years median
follow-up. The olaparib benefit was
consistent across all subgroups.
Preliminary data showed fewer
new cancers in the olaparib group
and a similar number of pregnancies
and pregnancy outcomes between
the arms.
See OlympiA at top right 
2024 SABCS®
| Takeaways
2024-SABCS-Takeaways

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