Dr Lynce on Ongoing Trials Evaluating Novel Combinations in Inflammatory Breast Cancer

Filipa Lynce, MD, senior physician, director, Inflammatory Breast Cancer Program, Dana-Farber Cancer Institute; assistant professor, medicine, Harvard Medical School, discusses 2 ongoing clinical trials investigating novel therapeutic combinations for the treatment of patients with inflammatory breast cancer.

First, Lynce highlights the phase 2 TRUDI trial (NCT05795101), which is enrolling patients with stage III HER2-positive and HER2-low inflammatory breast cancer. Patients are being treated with the neoadjuvant combination of fam-trastuzumab deruxtecan-nxki (T-DXd; Enhertu) and durvalumab (Imfinzi). Patients are allowed to have hormone receptor (HR)–positive or –negative disease; however, this must be known at enrollment. The combination of T-DXd and durvalumab is being given once every 3 weeks for up to 8 cycles prior to surgery. The trial is actively enrolling patients at both Dana-Farber Cancer Institute and MD Anderson Cancer Center, Lynce says.

Lynce also mentions cohort C of the phase 2 NeoSTAR trial (NCT04230109), which is specifically enrolling patients with HER2-negative inflammatory breast cancer, including those with HR-positive, HER2-negative and triple-negative subtypes. In this study, patients are receiving neoadjuvant treatment with sacituzumab govitecan-hziy (Trodelvy) along or in combination with pembrolizumab (Keytruda) for up to 4 cycles. Treatment is allowed to by followed by chemotherapy at the discretion of the treating physician. Lynce notes that this study could help determine if substituting paclitaxel with sacituzumab govitecan can yield better outcomes in a high-risk population.

As these trials continue to evolve, Lynce emphasizes the critical need for more dedicated clinical trials or specific cohorts within larger studies to accurately assess the efficacy of novel treatments for patients with inflammatory breast cancer. These focused investigations are essential to understanding the unique responses of patients with inflammatory breast cancer to existing and emerging therapies, thereby allowing the tailoring of future treatment strategies to improve their prognosis and quality of life, she concludes.