Matteo Lambertini, MD, PhD, IRCCS Ospedale Policlinico San Martino, Genova, Italy, reports updates from key breast cancer trials presented at ESMO 2021. Firstly, the randomized phase III DESTINY-Breast03 trial (NCT03529110) comparing trastuzumab emtansine (T-DM1) versus trastuzumab deruxtecan (T-DXd) shows a major improvement in median progression-free survival (PFS) for the T-DXd arm (7 months versus 25 months). Dr Lambertini predicts that the results from this trial will change the current second-line treatment for HER2-positive breast cancer. Dr Lambertini also discusses the TULIP trial (NCT03262935), which evaluates the efficacy of trastuzumab duocarmazine versus the physician’s drug choice. Results from this trial show a small but statistically significant improved median PFS for the SYD985 arm, but with relatively high rates of toxicity. Furthermore, the phase III MONALEESA-2 trial (NCT01958021) assessing the efficacy and safety of the CDK4/6 inhibitor ribociclib in postmenopausal endocrine-sensitive women with advanced breast cancer showed a 1-year improvement in median overall survival (OS). Importantly, the median OS exceeded 5 years for the first time in the context of advanced breast cancer. Dr Lambertini also mentions the phase III GIM4 trial (NCT01064635), which demonstrated that the best duration for adjuvant endocrine therapy for postmenopausal women is 7-8 years, including at least five years of treatment with aromatase inhibitors. Finally, Dr Lambertini reports data from the BrighTNess randomised phase III trial (NCT02032277) investigating the addition of veliparib plus carboplatin or carboplatin alone to standard neoadjuvant chemotherapy in patients with triple-negative breast cancer. This trial showed a clear benefit in event-free survival with the addition of carboplatin, as well as an increased pathological complete response (pCR) for patients taking carboplatin. This interview took place at the European Society for Medical Oncology (ESMO) 2021 congress.

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