Targeting Multiple Pathways Improves Outcomes in Some With Metastatic Breast Cancer

Findings from a recent clinical trial demonstrated a meaningful improvement in progression-free survival when Ibrance (palbociclib) was added to anti-HER2 therapy plus endocrine therapy in patients with HR-positive, HER2-positive metastatic breast cancer.

Results from the AFT-38 PATINA trial, which were presented at the 2024 San Antonio Breast Cancer Symposium (SABCS), also showed that finding these biomarkers by genetic testing can help identify patients best suited for particular treatments.

After SABCS, we spoke with CURE’s Editor-in-Chief, Dr. Debu Tripathy, about the potentially practice-changing data presented at the conference, one of which were from this trial. Tripathy is professor of medicine and chair of the department of breast medical oncology at The University of Texas MD Anderson Cancer Center in Houston.

Transcript:

Well, you know, we're making incremental progress. I think the main lesson for all of us that are in practice is to make sure that we are obtaining biomarkers on all of our patients, not only receptor status, but now using genomics. I think this is going to be an important aspect of the future.

I think the one immediately practice-changing area is going to be that we should be treating our patients by blockading all the accessible pathways. And in the PATINA study, in particular, it became clear that targeting both the HER2 pathway and the estrogen receptor pathway is important in patients who express both of those receptors.

We've hypothesized that for a long time. We've never done a randomized trial to prove it, but now we have randomized data that when you add the CDK inhibitor component to endocrine therapy, you do get a signal. So the first thing is, at least use the endocrine therapy, and then maybe the standard will change to use the CDK inhibitor therapy too.

That will be really up to the [Food and Drug Administration] to see if the data in the PATINA trial is robust enough to do that. I believe it is. It was a well-powered study. The signal is clear. It does help. The only downside is that we did see more diarrhea in that group, in the patients that got both the [Herceptin (trastuzumab) and Perjeta (pertuzumab)] along with CDK inhibitor therapy. So I think that that's an important thing to recognize.

And we need to continue to put patients on clinical trials. That's the big message, too. Open trials and put patients on it, because the field is moving quickly, and we need everybody's engagement in that.

So there are more granular things that I can share, but I think those are the big main messages.

For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.