Melissa K. Accordino, MD, MS, assistant professor of medicine, Division of Hematology/Oncology, Herbert Irving Comprehensive Cancer Center of Columbia University Medical Center, discusses the utility of liquid biopsies in breast cancer.

Liquid biopsies are being used in this space, says Accordino; however, the question of the reliability of liquid biopsy compared with tissue biopsy is still an ongoing area of debate. Liquid biopsies are more convenient, and if tissue cannot be collected, liquid biopsies are a good place to start. Archive tissue for next-generation sequencing can always be sent for as another option, concludes Accordino.

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Melissa K. Accordino, MD, MS, discusses the utility of liquid biopsies in breast cancer.

Dr. Accordino on Utility of Liquid Biopsies in Breast Cancer

Melissa K. Accordino, MD, MS, assistant professor of medicine, Division of Hematology/Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, discusses the findings of the phase III PEARL trial in hormone receptor (HR)—positive, HER2-negative metastatic breast cancer.

In the ongoing trial, investigators are comparing the use of the CDK4/6 inhibitor palbociclib plus either exemestane or fulvestrant versus capecitabine (Xeloda) in patients with HR-positive/HER2-negative metastatic breast cancer, says Accordino. Results showed no difference in efficacy with regard to progression-free survival (PFS), but the safety profiles were a bit different, adds Accordino. Among those patients who have already progressed on endocrine therapy, a CDK4/6 inhibitor and endocrine therapy might be a more favorable option over chemotherapy. The time to response was also similar in both arms of the study, which is reassuring, concludes Accordino.

Melissa K. Accordino, MD, MS, discusses the findings of the PEARL trial in hormone receptor-positive, HER2-negative metastatic breast cancer.

Dr. Accordino on Data From the PEARL Trial in HR+/HER2- Metastatic Breast Cancer

Melissa K. Accordino, MD, MS, assistant professor of medicine, Division of Hematology/Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, discusses the utility of CDK4/6 inhibitors in hormone receptor (HR)—positive, HER2-negative breast cancer.

Three CDK4/6 inhibitors, palbociclib (Ibrance), ribociclib (Kisqali), and abemaciclib (Verzenio) are approved for the frontline treatment of postmenopausal women with HR-positive, HER2-negative advanced or metastatic breast cancer. In July 2018, ribociclib was granted an expanded indication to include pre/perimenopausal women.

As such, CDK4/6 inhibitors have been widely adopted in the first-line setting as well as in the second-line setting for those who received alternative therapy in the first-line setting, explains Accordino.

Regarding efficacy, the trends for hazard ratio for progression-free survival are comparable across the phase III PALOMA-2, MONALEESA-7 and MONARCH 3 studies, says Accordino. The different toxicity profiles between palbociclib, ribociclib, and abemaciclib can help guide treatment selection.

Additionally, data suggest that abemaciclib has central nervous system activity. As such, patients with brain metastases may derive greater benefit with the agent compared with palbociclib or ribociclib, says Accordino.

Finally, abemaciclib can be given as a single agent as opposed to palbociclib and ribociclib, which are given with endocrine therapy, concludes Accordino.

Melissa K. Accordino, MD, MS, discusses the utility of CDK4/6 inhibitors in hormone receptor–positive, HER2-negative breast cancer.

Melissa K. Accordino, MD, MS

Articles

Dr. Accordino on Utility of Liquid Biopsies in Breast Cancer

Dr. Accordino on Data From the PEARL Trial in HR+/HER2- Metastatic Breast Cancer

Dr. Accordino on the Utility of CDK4/6 Inhibitors in HR+/HER2