Multigene sequencing identifies patients with metastatic breast cancer who will benefit from targeted therapy, but its use must be driven by a framework of actionability, show data presented at the 2021 San Antonio Breast Cancer Symposium.

The guideline was developed by a panel of 28 international experts in accordance with ESMO’s standard operating procedure  and replace the previous reference document, the 5th ESO–ESMO international consensus guidelines for advanced breast cancer.

ESMO Congress 2021; 16–21 September

Previously treated patients with HER2-positive metastatic breast cancer derive a significant progression-free survival benefit from the novel HER2-targeted antibody–drug conjugate trastuzumab duocarmazine relative to standard treatment, shows the TULIP trial.

Extending adjuvant aromatase inhibitor therapy with letrozole to 5 years improves survival among women with hormone receptor-positive breast cancer who have already received 2 to 3 years of tamoxifen, shows the phase 3 GIM4 trial.

The final overall survival findings from the MONALEESA-2 trial confirm the long-term benefits of combining ribociclib with first-line letrozole for postmenopausal women with advanced hormone receptor-positive, HER2-negative breast cancer.

Previously treated patients with HER2-positive metastatic breast cancer derive a significant progression-free survival benefit from trastuzumab deruxtecan relative to trastuzumab emtansine, find the DESTINY-Breast03 investigators.

Adding carboplatin to neoadjuvant paclitaxel is sufficient to boost the outcomes of patients with triple-negative breast cancer, with no further improvement from the addition of veliparib to the dual regimen, confirms a follow-up analysis of the BrighTNess trial.

Neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab significantly improves event-free survival rates versus neoadjuvant chemotherapy alone in people with a new diagnosis of early-stage triple-negative breast cancer, KEYNOTE-522 study data show.

Adding atezolizumab to neoadjuvant dual-HER2 blockade plus chemotherapy does not boost pathologic complete response rates in people with high-risk, HER2-positive, early breast cancer, find the IMpassion050 investigators.

The BERENICE investigators report a low incidence of cardiac events with the use of pertuzumab–trastuzumab-based neoadjuvant and adjuvant regimens in patients with HER2-positive, early breast cancer after 5 years of follow-up.

The quality of life of postmenopausal women with advanced hormone receptor-positive, HER2-negative breast cancer remains largely unchanged by the addition of palbociclib to first-line fulvestrant, suggest data from the FLIPPER trial.

Paired analysis of primary and relapsed breast cancer specimens shows that many HER2-negative patients switch between HER2-low and HER2-0 expression during disease progression.

Early results from the GELATO trial point to the potential of atezolizumab plus carboplatin for the treatment of metastatic invasive lobular breast cancer.

Long-term results from the ShortHER trial of adjuvant trastuzumab de-escalation provide reassurance for patients with HER2-positive, early breast cancer who may need to discontinue treatment before completing the standard 1-year course.

TROPION-PanTumor01 trial findings suggest that the TROP2-directed antibody–drug conjugate datopotamab deruxtecan might offer a novel treatment option for patients with advanced triple-negative breast cancer.

The long-term benefit of endocrine therapy in premenopausal women with breast cancer may be influenced by molecular risk, suggest Swedish findings.

The researchers measured QoL benefits using the ASCO Value Framework (ASCO-VF) version 2.0 and the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS) version 1.1 QoL bonus criteria.