Optimizing Treatment Strategies for HR+/HER2- Breast Cancer: ESR1 Mutations and Emerging Therapies

Virginia Kaklamani, MD, DSc, and Heather McArthur, MD, explore the evolving landscape of HR+/HER2- metastatic breast cancer management, focusing on the clinical implications of ESR1 and PIK3CA mutations, the role of biomarker testing, the impact of novel therapies and combination strategies, and the importance of personalized treatment approaches in improving patient outcomes.

EP. 1: Prevalence and Testing Strategies for ESR1

June 25th 2024

Virginia Kaklamani, MD, DSc, and Heather McArthur, MD, explore the clinical significance of *ESR1* mutations in HR+/HER2- metastatic breast cancer patients, including their impact on disease prognosis, treatment outcomes, and the increasing prevalence of these mutations with each line of endocrine therapy, ultimately informing their therapeutic approach.

EP. 2: Evolution of Testing Strategies for ESR1

June 25th 2024

The key opinion leaders (KOLs) review the current testing methods for detecting ESR1 mutations and explore the existing strategies employed to overcome or delay the development of these mutations and the associated endocrine resistance in patients with HR+/HER2- metastatic breast cancer.

EP. 3: Dynamics of ESR1 Alterations and Serial Liquid Biopsies

July 1st 2024

In their discussion, medical experts in the field of breast cancer explore the role of liquid biopsies and compare the significance of ESR1 mutations to other biomarkers, such as PIK3CA, in terms of their driver versus passenger status in the context of HR+/HER2- breast cancer.

EP. 4: Case Presentation 1: PIK3CA Mutation With ESR1 Mutations

July 1st 2024

Virginia Kaklamani, MD, DSc, and Heather McArthur, MD, present a patient case involving a 54-year-old postmenopausal woman diagnosed with a 2.1cm estrogen receptor positive (ER+), HER2 negative breast cancer, and discuss the clinical implications and management strategies for this specific patient scenario.

EP. 5: EMERALD Study Design and Results for Elacestrant

July 8th 2024

Key opinion leaders examine the EMERALD trial, which evaluates the efficacy of elacestrant in patients with HR+ HER2- metastatic breast cancer, focusing on the subgroup analysis of patients with visceral metastases, and explore how the trial's design and results have influenced their clinical practice.

EP. 6: Evolving Best Practices for ESR1 Testing

July 8th 2024

The breast cancer experts share their clinical experiences and strategies regarding the optimal timing for testing ESR1 mutations in patients with HR+/HER2- metastatic breast cancer, elaborating on how the specific points in the treatment journey at which they recommend testing influence their subsequent treatment decisions and overall approach to patient management.

EP. 7: Case Presentation 2: Co-mutations in ESR1 and PIK3CA

July 15th 2024

Virginia Kaklamani, MD, DSc, and Heather McArthur, MD, discuss the clinical presentation and management of a 64-year-old postmenopausal female with a history of rheumatoid arthritis who was diagnosed with stage IV, grade 3, invasive ductal carcinoma in her left breast, taking into account her comorbidities and the advanced stage of her breast cancer.

EP. 8: PIK3CA Mutations and Delivering PI3K Inhibitors

July 15th 2024

In their discussion, the key opinion leaders explore the significance of PIK3CA mutations in HR+/HER2- metastatic breast cancer and review the findings from two pivotal clinical trials, SOLAR-1 and CAPItello-291, which investigated the efficacy of targeted therapies in patients harboring these mutations.

EP. 9: PostMONARCH: Dissecting Data on Sequential CDK 4/6 Inhibitors

July 22nd 2024

The expert panel examines the subgroup data from the postMONARCH study, focusing on patients with ESR1 and PIK3CA mutations, and emphasizes the important role of CDK4/6 inhibitors in the treatment of these specific patient populations with HR+/HER2- metastatic breast cancer.

EP. 10: Combinations and Treatment Sequence Strategies in Breast Cancer

July 22nd 2024

In their discussion, the key opinion leaders explore the potential of combination therapies in HR+/HER2- metastatic breast cancer, with a specific focus on the ELECTRA study, which investigated the combination of elacestrant and abemaciclib.