In TALENT, adding anastrozole did not increase pCR.
In light of these data, how should we approach concurrent ET with T-DXd in DB-05/09? Are subgroup results by ET use available?
What are your thoughts?
#ESMO26
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Final results of TALENT: A neoadjuvant trial of T-DXd with or without anastrozole, or in sequence with chemotherapy for HER2-low, HR+ early-stage breast cancer
https://esmocongress.esmo.org#ESMO26 | TALENT Neoadjuvant T-DXd showed very low pCR rates in HR+/HER2-low early breast cancer: - T-DXd: 7% - T-DXd + anastrozole: 3% - T-DXd → chemotherapy: 9% We should remember that pCR is a limited surrogate endpoint in HR+ disease. However, these results do not support T-DXd as an alternative to standard neoadjuvant chemotherapy. Moreover, given the heterogeneity of HER2-low disease, I find it unsurprising that the success of T-DXd in the metastatic setting does not translate into similar outcomes in early-stage disease, despite the lower tumor burden.在 X 查看被引用的帖子
- tatsunori_shimoi 下井辰徳@shimoi_oncology
Thank you. You’re absolutely right, but since the DB08 trial wasn’t designed to assess whether DB08 actually provides an additional benefit to endocrine therapy when used alone, and since—like the TALENT trial—it didn’t include HER2-positive patients, I personally remain skeptical about combining it with endocrine therapy.
- Benjamin Walbaum, MD@benjiwal
@dr_yakupergun @OncBrothers @stolaney1 @drsarahsam @hoperugo @Dr_RShatsky @SuyogCancer @PTarantinoMD @Lucarecco @ErikaHamilton9 @shimoi_oncology @ValenzaCarmine @DrBarbiOnc @AnisToumeh @MamMa_mimumemo @JAMouabbi @aftimosp @CCortiMD @BianchiniGP @WLybaert @kazuki_nozawa There is data from de DB08 ph Ib trial with TDXD + anastrazole or fulvestrant within HER2 low ABC, with ORR of 70 and 40% respectively. Only 13.5% of patients in DB09 received concurrent ET 😒, so we cannot evaluate the benefit here. Still PCR seems a limited outcome here.
- Anis Toumeh, MD@AnisToumeh
@dr_yakupergun @OncBrothers @stolaney1 @drsarahsam @hoperugo @Dr_RShatsky @SuyogCancer @PTarantinoMD @benjiwal @Lucarecco @ErikaHamilton9 @shimoi_oncology @ValenzaCarmine @DrBarbiOnc @MamMa_mimumemo @JAMouabbi @aftimosp @CCortiMD @BianchiniGP @WLybaert @kazuki_nozawa 2/2 Also, Is there a benefit from adding ET in the neoadj settings that is not captured by the magnitude or pathologic response? Is some path response good enough in HR+/HER2+ disease? I have contemplated these questions for a while.
- Anis Toumeh, MD@AnisToumeh
@dr_yakupergun @OncBrothers @stolaney1 @drsarahsam @hoperugo @Dr_RShatsky @SuyogCancer @PTarantinoMD @benjiwal @Lucarecco @ErikaHamilton9 @shimoi_oncology @ValenzaCarmine @DrBarbiOnc @MamMa_mimumemo @JAMouabbi @aftimosp @CCortiMD @BianchiniGP @WLybaert @kazuki_nozawa 1/2 Good question. To me, I want to make sure there is no harm (as opposed to added benefit), In MBC, I don't like leaving the HR pathway unchecked whenever I can. My practice has been to prescribe ET with ADCs in MBC as well as adjuvant.
- Yakup Ergün@dr_yakupergun
@OncBrothers @stolaney1 @drsarahsam @hoperugo @Dr_RShatsky @SuyogCancer @PTarantinoMD @benjiwal @Lucarecco @ErikaHamilton9 @shimoi_oncology @ValenzaCarmine @DrBarbiOnc @AnisToumeh @MamMa_mimumemo @JAMouabbi @aftimosp @CCortiMD @BianchiniGP @WLybaert @kazuki_nozawa
Source: Yakup Ergün · x.com