— Virginia Kaklamani, MD, discusses this year’s sessions of interest and looks ahead to next year
Greg Laub, Director, Video, MedPage Today
December 22, 2023
In this exclusive MedPage Today video, Virginia Kaklamani, MD, DSc, of UT Health Sciences Center in San Antonio and co-director of the San Antonio Breast Cancer Symposium (SABCS), highlights some of the most impactful and paradigm-shifting sessions in breast cancer presented at this year’s symposium — and provides some insight into what questions might be answered in the next year.
The following is a transcript of her remarks:
This year has been the 46th year of having the symposium. The symposium started as a small meeting of 30 physicians, mostly a tumor board between experts and local physicians in San Antonio. It then grew into the largest symposium of breast cancer in the world. We have researchers from all over the world — almost a hundred countries — coming here and really sharing their views, exchanging ideas, and trying to move the field forward.
The symposium this year had several sessions that I think are critical. We had a prevention session. We had a lobular carcinoma session and an inflammatory breast cancer session. It also had a lot of data on local therapy, mostly how to de-escalate our therapy, how to not give radiation if we don’t have to, how to not do axillary node dissection if we don’t have to. And this really improves the morbidity of our patients.
And it also had really exciting data on combination therapy such as the INAVO120 trial, looking at combination of a PI3 kinase inhibitor, a CDK4/6 inhibitor and endocrine therapy, and also our HER2CLIMB-02 trial, looking at a combination of T-DM1 [trastuzumab emtansine, Kadcyla] and tucatinib [Tukysa] in patients with metastatic HER2-positive breast cancer. So I think come Monday morning, we’re going to be changing our practice quite a bit based on the data that was presented this year at SABCS.
So 2024, we’re going to have some answers to several key questions. The first question is, can we sequence CDK4/6 inhibitors? Can we give a CDK4/6 inhibitor, and at disease progression give another one? And we’re going to have answers from the postMONARCH trial, which are going to again change our standard of care.
We’re also going to have some data on other oral SERDs [selective estrogen receptor degraders]. This year we had the approval of elacestrant [Orserdu] based on clinical trial data, suggesting that it’s active in tumors that have ESR1 mutations. Next year we’re going to have some data from two other oral SERDs — imlunestrant and camizestrant — in combination with other treatments. So I think that’ll be pretty exciting and hopefully more drug approvals for our patients.
And then we had some data this year looking at immunotherapy in a high-risk hormone receptor-positive early stage breast cancer. But I think it’ll be important to see what subset, molecular subset of patients derive most of the benefit. So this is something that I think is going to be explored next year.
And then we’re going to have some readouts in triple-negative breast cancer trials — again, looking at tweaking of immunotherapy and antibody drug conjugates that have been really the big story for the last 2 or 3 years — are going to continue to give us data and hopefully provide us more agents, more active agents for our patients.