ESMO 2019 — Overview of Presidential Symposium II: breast cancer


  • Ben Gallarda
  • Oncology Conference reports
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The second Presidential Symposium of ESMO 2019 included results from two trials of CDK4/6 inhibitors in HR+/HER2- breast cancer, a drastic improvement in early triple-negative breast cancer (TNBC) with add-on immunotherapy, and the latest advances in PARP inhibition.

Takeaway

Abemaciclib plus fulvestrant in patients with HR+, HER2- breast cancer:

  • Addition of abemaciclib resulted in a median OS of 46.7 vs 37.3 months with fulvestrant plus placebo (HR 0.757) and a median time to chemotherapy of 50.2 vs 22.1 months (HR 0.625, exploratory analysis).
  • Study included pre-, peri-, and post-menopausal patients, and benefit was seen in subgroups with poor prognoses, like visceral metastases.

Postmenopausal patients with HR+, HER2- breast cancer treated with fulvestrant plus ribociclib or placebo:

  • Overall median OS was not reached, vs 40.0 months with placebo (HR 0.724).
  • Patients with early relapse or receiving second-line (post-endocrine) therapy saw a median OS of 40.2 (vs 32.5 months, HR 0.730), and median OS was not reached in patients receiving first-line therapy (vs 45.1 months, HR 0.700).

Neoadjuvant pembrolizumab plus chemotherapy, followed by adjuvant pembrolizumab for TNBC:

  • With median follow-up of 15.5 months, pathological complete response (pCR) was 64.8% vs 51.2% with neoadjuvant chemotherapy plus placebo.
  • pCR rates improved in both PD-L1 positive (68.9% vs 54.9%) and PD-L1 negative (45.3% vs 30.3%) patients.
  • Full coverage on Univadis.

Veliparib with carboplatin and paclitaxel in HER2-, BRCA-mutated breast cancer:

  • Investigator-assessed median PFS was 14.5 vs 12.6 months with chemotherapy plus placebo (HR 0.705) and independent review committee-assessed median PFS was 19.3 vs 13.5 months (HR 0.695).
  • Interim median OS had not yet reached significance (33.5 vs 28.2 months, HR 0.945).

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