SAN ANTONIO BREAST CANCER SYMPOSIUM
December 7-11, 2021
  • General Session 1
  • General Session 2
  • General Session 3
  • General Session 4
General Session 1

 

Publication Number: GS1-00:

GS1-00. Single-cell spatial analysis by imaging mass cytometry and immunotherapy response in triple-negative breast cancer (TNBC) in the NeoTRIPaPDL1 trial

Giampaolo Bianchini, Xiao Qian Wang, Esther Danenberg, et al.

Overall, the authors were able to show in their large, randomized study that IMC is feasible and provides independent predictive information on the benefit of immune checkpoint inhibitors for PD-L1, TILs and gene expression profiles.

 

Publication Number: GS1-01:

KEYNOTE-522 study of neoadjuvant pembrolizumab + chemotherapy vs placebo + chemotherapy, followed by adjuvant pembrolizumab vs placebo for early-stage TNBC: Event-free survival sensitivity and subgroup analyses

Peter Schmid, Javier Cortes, Rebecca Dent, et al.

The authors conclude that the EFS sensitivity analyzes revealed a robust and generally consistent treatment benefit of neoadjuvant pembro + chemotherapy followed by adjuvant pembro across a wide range of patient subgroups in previously untreated, non-metastatic triple-negative breast cancer.

 

Publication Number: GS1-02

Final results of KEYNOTE-355: Randomized, double-blind, phase 3 study of pembrolizumab + chemotherapy vs placebo + chemotherapy for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer

Javier Cortes, David W. Cescon, Hope S. Rugo, et al.

The authors conclude that the study shows that CPS ≥ 10 is a reasonable cut-off to define the patient population with metastatic triple negative breast cancer who could benefit from Pembro + chemotherapy.

 

Publication Number: GS1-05

Datopotamab deruxtecan in advanced/metastatic HER2- breast cancer: Results from the phase 1 TROPION-PanTumor01 study 

Ian Krop, Dejan Juric, Toshio Shimizu, et al.

The authors conclude that Dato-DXd has shown promise in antitumor activity in patients with previously treated advanced / metastatic triple negative breast cancer. The security profile is manageable.

 

Publication Number: GS1-06

A randomized control phase III trial of entinostat, a once weekly, class I selective histone deacetylase inhibitor, in combination with exemestane in patients with hormone receptor positive advanced breast cancer 

Binghe Xu, Qingyuan Zhang, Xichun Hu, et al.

The authors conclude that compared with exemestane monotherapy, entinostat plus exemestane significantly improved progression-free survival in HR-positive, HER2-negative breast cancer that had progressed after previous endocrine therapy. The combination was generally tolerated and may offer important clinical benefit in these patients.

 

Publication Number: GS1-07 

Adjuvant palbociclib in HR+/HER2- early breast cancer: Final results from 5,760 patients in the randomized phase III PALLAS trial 

Michael Gnant, Amylou C Dueck, Sophie Frantal, et al.

The authors conclude that this analysis of the PALLAS study shows that adding 2 years of palbociclib to ongoing adjuvant endocrine therapy did not improve survival endpoints for patients with HR + / HER2-eBC stage II-III.

 

Publication Number: GS1-08 

GS1-08. CCTGMA.32, a phase III randomized double-blind placebo controlled adjuvant trial of metformin (MET) vs placebo (PLAC) in early breast cancer (BC): Results of the primary efficacy analysis (clinical trials.gov NCT01101438)

Pamela J. Goodwin, Bingshu E Chen, Karen A Gelmon, et al.

The authors conclude that MET did not improve IDFS or other BC results and should not be used as an adjuvant treatment.

 

Publication Number: GS1-09 

Inhibition of GPX4 induces preferential death of p53-mutant triple-negative breast cancer cells 

William M Tahaney, Jing Qian, Reid Powell, et al.

With their studies, the authors provide the scientific basis for the further development of ferroptosis inducers for the targeted treatment of p53-mutated breast cancer. For more information see the abstract.

 

Publication Number: GS1-10 

GS1-10. Clinical utility of molecular tumor profiling: Results from the randomized trial SAFIR02-BREAST

Fabrice André, Anthony Gonçalves, Thomas Filleron, et al.

SAFIR02/PI3K studies show that the clinical application of multigene sequencing must take place within a framework that determines whether it can lead to clinical action. Multigene sequencing identifies novel genomic changes associated with the development of metastases and drug resistance or sensitivity.

General Session 2

 

Publication Number: GS2-00.

Correlative analysis of overall survival by intrinsic subtype across the MONALEESA-2, -3, and -7 studies of ribociclib + endocrine therapy in patients with HR+/HER2− advanced breast cancer

Lisa Carey, Nadia Solovieff, Fabrice André, et al.

The authors' analysis confirmed the prognostic and predictive value of intrinsic subtype (PAM50 based) for OS. The addition of RIB to ET resulted in consistent OS benefit across all subtypes except for basal-like.

 

Publication Number: GS2-01.

Overall survival subgroup analysis by metastatic site from the phase 3 MONALEESA-2 study of first-line ribociclib + letrozole in postmenopausal patients with advanced HR+/HER2− breast cancer

Joyce O'Shaughnessy, Salomon M Stemmer, Howard A Burris, et al.

The study demonstrated with this prespecified exploratory analysis an OS benefit with RIB + LET independent of the site and number of metastatic lesions.

 

Publication Number: GS2-02.

Elacestrant, an oral selective estrogen receptor degrader (SERD), vs investigator’s choice of endocrine monotherapy for ER+/HER2- advanced/metastatic breast cancer (mBC) following progression on prior endocrine and CDK4/6 inhibitor therapy: Results of EMERALD phase 3 trial

Aditya Bardia, Patrick Neven, Guillermo Streich, et al.

The first oral SERD Elacestrant demonstrate a statistically significant and clinically meaningful improvement of PFS vs SOC. It was well tolerated and the authors conclude that the drug has the potential to become the new standard of care for pts with ER+/HER2- mBC.

 

Publication Number: GS2-04 

Aromatase inhibitors versus tamoxifen in pre-menopausal women with estrogen receptor positive early stage breast cancer treated with ovarian suppression: A patient level meta-analysis of 7,030 women in four randomised trials 

Rosie Bradley, Jeremy Braybrooke, Richard Gray1, et al.

AI instead of tamoxifen reduces the risk of breast cancer recurrence by about 20 percent in premenopausal women with ovarian suppression. The authors conclude: "If the surprising lack of benefit in N4 + disease is an incidental finding, then the absolute benefit is greater for women with a higher absolute risk of recurrence."

 

Publication Number: GS2-05.

Randomized comparison of adjuvant aromatase inhibitor exemestane (E) plus ovarian function suppression (OFS) vs tamoxifen (T) plus OFS in premenopausal women with hormone receptor-positive (HR+) early breast cancer (BC): update of the combined TEXT and SOFT trials

Meredith M Regan, Barbara A Walley, Gini F Fleming, et al.

After 13 years adjuvant E+OFS, as compared with T+OFS, shows a sustained reduction in the recurrence-risk, more consistent in HER2 negative patients and in those with high-risk disease features.

 

Publication Number: GS2-06 

Taxane with anthracycline versus taxane without anthracycline: An individual patient-level meta-analysis of 16,500 women with early-stage breast cancer in 13 randomised trials 

Jeremy Braybrooke, Rosie Bradley, Richard Gray, et al.

Anthracycline in addition to taxane chemotherapy reduced the risk of breast cancer recurrence by 18 percent compared to Taxane Mono.

 

Publication Number: GS2-07 

Updated results from a phase 3 randomized clinical trial in participants (pts) with 1-3 positive lymph nodes (LN), hormone receptor-positive (HR+) and HER2-negative (HER2-) breast cancer (BC) with recurrence score (RS) < 25 randomized to endocrine therapy (ET) +/- chemotherapy (CT): SWOG S1007 (RxPONDER) 

Kevin M Kalinsky, William E Barlow, Julie R Gralow, et al. 

Premenopausal patients with 1-3 + LN and RS <25 demonstrated a statistically significant improvement in DRFI with additional CT. A small proportion of the S1007 premenopausal participants underwent ovarian function suppression.

 

Publication Number: GS2-09.

Tamoxifen instigates uterine cancer development by activating PI3K signaling and supersedes PIK3CA driver mutations

Kirsten Kubler, Agostina Nardone, Shankara Anand, et al.

The authors describe a distinct and novel pathway of carcinogenesis in which tamoxifen acts as a driver event in the uterus and promotes tumor development in a mutation-independent manner.

 

Publication Number: GS2-10.

Nimbus: A phase 2 trial of nivolumab plus ipilimumab for patients with hypermutated her2-negative metastatic breast cancer (MBC)

Romualdo Barroso-Sousa, Tianyu Li, Sangeetha Reddy, et al.

The authors conclude, that the study  achieved the primary endpoint and demonstrated a confirmed ORR of 13.3%.

 

General Session 3

 

Publication Number: GS3-01

Trastuzumab deruxtecan (T-DXd; DS-8201a) vs. trastuzumab emtansine (T-DM1) in patients (pts) with HER2+ metastatic breast cancer (mBC): subgroup analyses from the randomized phase 3 study DESTINY- Breast03

Sara Hurvitz, Sung-Bae Kim, Wei-Pang Chung, et al.

DESTINY-Breast03 is the first reported randomized phase 3 study comparing T-DXd with standard of care treatment. It met the primary endpoint and T-DXd demonstrated superior PFS over T-DM1 and T-DXd with a manageable safety profile. A consistent PFS and ORR benefit with T-DXd vs. T-DM1 was seen in all HER2 + metastatic breast cancer subgroups previously treated with trastuzumab and taxane, including patients with brain metastases.

 

Publication Number: GS3-02.

Updated overall survival (OS) results from the phase 3 PHOEBE trial of pyrotinib versus lapatinib in combination with capecitabine in patients with HER2-positive metastatic breast cancer

Binghe Xu, Min Yan, Fei Ma, et al.

Pyrotinib plus capecitabine demonstrated a statistically significant OS improvement compared with lapatinib plus capecitabine in HER2-positive MBC after trastuzumab and chemotherapy. According to the authors, this reaffirms pyrotinib plus capecitabine as an established treatment option in this patient population

 

Publication Number: GS3-03

Genomic analysis of 733 HER2+ breast cancers identifies recurrent pathways alterations associated with anti-HER2 resistance and new therapeutic vulnerabilities

Emanuela Ferraro, Alison Smith, Anton Safonov, et al.

PIK3CA-activating mutations detected by tumor sequencing and the lack of genomic ERBB2 amplification are associated with reduced progression-free survival in HP-based therapy. The clinical-genomic analysis of the mechanisms of resistance clearly identified changes in the MAPK signaling pathway as additional potential drivers of resistance to anti-HER2 therapy. The authors speculate that inhibiting the PI3K or MAPK signaling pathway in such tumors could be a new therapeutic strategy to expand the H / P utility.

 

Publication Number: GS3-05.

Fulvestrant-palbociclib vs continuing aromatase inhibitor-palbociclib upon detection of circulating ESR1 mutation in HR+ HER2- metastatic breast cancer patients: Results of PADA-1, a UCBG-GINECO randomized phase 3 trial

François-Clément Bidard, Anne-Claire Hardy-Bessard, Thomas Bachelot, et al.

PADA-1 reached its primary objective and demonstrates that targeting bESR1mut-associated resistance through a change in the endocrine partner of palbociclib is feasible and allows a doubling in the subsequent median PFS.

 

Publication Number: GS3-06.

Primary results of the cTRAK TN trial: A clinical trial utilising ctDNA mutation tracking to detect minimal residual disease and trigger intervention in patients with moderate and high risk early stage triple negative breast cancer

Nicholas Turner, Claire Swift, Ben Jenkins, Lucy Kilburnet al.

The authors' findings have implications for future trial design, emphasizing the importance of early start of ctDNA testing, and more sensitive and/or more frequent ctDNA testing regimes.

 

Publication Number: GS3-07

Circulating tumor DNA (ctDNA) dynamics in patients with hormone receptor positive (HR+)/HER2 negative (HER2-) advanced breast cancer (aBC) treated in first line with ribociclib (R) and letrozole (L) in the BioItaLEE trial

Giampaolo Bianchini, Luca Malorni, Grazia Arpino, et al.

The authors demonstrated, that the pretreatment and early dynamics of the ctDNA (assessed by NGS) are promising prognostic and predictive biomarkers in patients with HR + / HER2-aBC treated first-line with ribociclib / letrozole.

 

Publication Number: GS3-09

Loss of ASXL1 tumor suppressor promotes resistance to CDK4/6 inhibitors in ER+ breast cancer

Dhivya R. Sudhan, Sumanta Chatterjee, Jiwoong Kim, et al.

CDK2 inhibitors can be a treatment approach for drug-resistant tumors. For more information please consult the abstract.

 

Publication Number: GS3-10

Study of samuraciclib (CT7001), a first-in-class, oral, selective inhibitor of CDK7, in combination with fulvestrant in patients with advanced hormone receptor positive HER2 negative breast cancer (HR+BC)

Charles Coombes, Sasha J Howell, Matthew G Krebs, et al.

Samuraciclib plus fulvestrant shows an acceptable safety profile with evidence of anti-tumor activity in advanced HR + BC after previous CDK4 / 6i therapy.

General Session 4

 

Publication Number: GS4-01.

Impact of race and ethnicity on incidence and severity of breast cancer related lymphedema after axillary lymph node dissection: Results of a prospective screening study

Andrea V. Barrio, Giacomo Montagna, Varadan Sevilimedu, et al.

Black and Hispanic women had a higher incidence of BCRL development compared to Caucasian women, with Black race being the strongest predictor of BCRL development and of severe BCRL.

 

Publication Number: GS4-02.

Analysis of clinical outcomes and expression-based immune signatures by race in the I-SPY 2 trial

Beverly Kyalwazi, Christina Yau, Olufunmilayo Olopade, et al.

Among women with high-risk breast cancer, race does not affect subtype-specific response rates nor event-free survival. Hence, race is less likely than tumor biology to predict response. The decreased expression of immune signatures observed in Black or African American women with TNBC suggests possible differential sensitivity to immunotherapy plus combination chemotherapy.

 

Publication Number: GS4-03

Patient-reported outcomes (PROs) for the intergroup sentinel mamma study (INSEMA, GBG75, ABCSG43): Persistent impact of axillary surgery on arm and breast symptoms in early breast cancer

Bernd Gerber, Angrit Stachs, Kristina Veselinovic, et al.

The authors conclude from the data that patients without SLNB benefited in terms of arm symptoms/function. There were no relevant differences in other QoL scales.

 

Publication Number: GS4-05

Preservation of axillary lymph nodes compared to complete dissection in T1-T2 breast cancer patients presenting 1-2 metastatic sentinel lymph nodes. A multicenter randomized clinical trial. Sinodar one

Damiano Gentile, Wolfgang Gatzemeier, Erika Barbieri, et al.

The OS rate in the standard and experimental arm was over 99 percent; The DFS rate is 96.8% and 95.9% in the standard and experimental arms, respectively. After a median of 36 months, there was only one axillary relapse in the experimental arm. Seven distant relapses were observed in both arms and four and three deaths in the standard and experimental arms, respectively.

 

Publication Number: GS4-06

Estimation of breast cancer overdiagnosis in a US breast screening cohort

Marc D Ryser, Jane Lange, Lurdes Inoue, et al.

Overdiagnosis of screen-detected cancers is less common than in studies with excessive incidence estimates and more common than estimates in previous modeling studies that did not consider indolent tumors.

 

Publication Number: GS4-07

The Breast PreCancer Atlas DCIS genomic signatures define biology and correlate with clinical outcomes: An analysis of TBCRC 038 and RAHBT cohorts

Siri H Strand, Belén Rivero-Gutiérrez, Kathleen E Houlahan, et al.

Genomic profiling in two independent DCIS cohorts with longitudinal section results provides different DCIS stroma expression patterns and immune cell compositions. RNA expression profiles provide information about the underlying tumor biology associated with later iBEs in both cohorts. In doing so, they gain new insights into DCIS biology and guide the development of diagnostic strategies to prevent invasive progression.

 

Publication Number: GS4-08

Comprehensive genomic profiling of patients with breast cancer identifies germline-somatic interactions mediating therapy resistance

Anton Safonov, Chai Bandlamudi, Paulino Tallón de Lara, et al.

The analysis of germline-somatic interactions revealed new associations relevant to breast cancer progression and treatment resistance. BRCA2 carriers have worse results than the first-line CDK4 / 6i-ET. This has potential implications for optimal first-line therapy and sequencing of CDK4 / 6i versus PARPi in this patient population.

 

Publication Number: GS4-09.

Quality of life results from OlympiA: A phase III, multicenter, randomized, placebo-controlled trial of adjuvant olaparib after (neo)-adjuvant chemotherapy in patients with germline BRCA1/2 mutations and high-risk HER-2 negative early breast cancer

Patricia A Ganz, Hanna Bandos, Tanja Spanic, et al.

According to the authors, increased treatment-emergent symptoms with OL were small and resolved after treatment. QOL scores were similar and slowly improved during the 24 months after (neo) adjuvant chemotherapy.

Publication Number: GS4-10

Neratinib + fulvestrant + trastuzumab for hormone receptor-positive, HER2-mutant metastatic breast cancer and neratinib + trastuzumab for triple-negative disease: Latest updates from the SUMMIT trial

Komal Jhaveri, Haeseong Park, James Waisman, et al.

Neratinib + fulvestrant + trastuzumab (N+F+T ) is a promising combination for patients with HR +, HER2-mutant MBC with prior exposure to CDK4 / 6 inhibitors. Neratinib + trastuzumab also showed encouraging activity on HER2 mutant TNBC. The first results from the randomized comparison of N + F + T vs. F + T vs. F in patients with HR +, HER2-mutated MBC (Simon stage 1 analysis) will be presented at the conference.

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