Komal L. Jhaveri, MD, FACP, medical oncologist, Memorial Sloan Kettering Cancer Center, discusses acquired resistance to CDK 4/6 inhibitors in breast cancer.

Preclinical data may justify combination regimens to address acquired resistance to CDK 4/6 inhibitors, says Jhaveri. Some adaptive responses to CDK 4/6 inhibition may lead to activation of the PI3K pathway. That, Jhaveri says, has justified a triplet combination to be evaluated in the clinic. That is an ongoing effort.

 amplification could be 1 mechanism of resistance. An early data set from the MONALEESA-2 trial showed that 

 amplification from baseline circulating tumor DNA has limited progression-free survival benefit. Though small in number, Jhaveri says it parallels the data that show that 

 amplification is a resistance mechanism.

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Dr. Jhaveri on Acquired Resistance to CDK 4/6 Inhibitors in Breast Cancer

Komal L. Jhaveri, MD, assistant professor, Department of Medicine, NYU Langone Medical Center, discusses T-DM1 for neoadjuvant breast cancer treatment.

Jhaveri says T-DM1 is already being looked at in the neoadjuvant setting. In one trial, researchers are looking to incorporate T-DM1 into the upfront setting and will evaluate two arms: docetaxel, carboplatin, and trastuzumab (TCH) versus T-DM1 plus pertuzumab. In the KATHERINE trial, patients who did not achieve pathologic complete response will be randomized to T-DM1 or trastuzumab in the adjuvant setting.

T-DM1 is being used in different ways, Jhaveri says, and it’s utility in the neoadjuvant setting remains to be seen.

Komal L. Jhaveri, MD, assistant professor, Department of Medicine, NYU Langone Medical Center, discusses T-DM1 for neoadjuvant breast cancer treatment.


Komal L. Jhaveri, MD

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Dr. Jhaveri on Acquired Resistance to CDK 4/6 Inhibitors in Breast Cancer

Dr. Jhaveri on T-DM1 in the Neoadjuvant Setting