A) EARLY BREAST CANCER
1. MonarchE 7-year update
Adjuvant Abemaciclib + Endocrine Therapy significantly reduced risk of death by 16% compared to adjuvant Endocrine therapy alone (HR 0.84, p = 0.0273). This is the first overall-survival benefit of adjuvant CDK4/6 inhibitors.
In addition, adding Abemaciclib also continues to reduce the risk of invasive cancer recurrence by 27% and distant metastases by 25% (IDFS HR 0.73; DRFS HR 0.75).
2. NATALEE 5-year data
Adjuvant Ribociclib + NSAI significantly reduced the risk of invasive relapse by 28 % in high risk stage II and stage III ER+/HER2- Breast cancer versus endocrine therapy alone (IDFS HR 0.716, p < 0.0001). Interestingly, the observed benefit extends to the node-negative cohort.
In addition, there is a positive OS trend (HR 0.80) but still immature data
3. DESTINY-Breast05
Compared adjuvant T-DXd vs T-DM1 in patients with residual invasive disease and high risk features after neoadjuvant anti-HER2 based therapy. T-DXD significantly reduced the risk of invasive relapse by 53 % (iDFS HR: 0.47)
In addition, there was numerically lower risk of brain mets (BMFI HR: 0.64)
4. DESTINY-Breast11
Compared T-DXd x4 + THPx4 versus the classical AC x4 + THP x4 in the neoadjuvant therapy of high risk early HER2+ Breast cancer.
T-DXD increased the chance of achieving PCR from 56.3 %to 67.3 % versus the anthracycline based regimen with less side effects .
