Dr. Yardley on Importance of Tailoring Treatment to Breast Cancer Subtypes

Denise Yardley, MD, senior investigator, Sarah Cannon Research Institute, discusses the importance of tailoring treatment approaches to the different subtypes of patients with breast cancer.

This past year saw significant advancements made across breast cancer histologies in terms of creating a more precise approach for patients, Yardley says. In early-stage breast cancer, an important questions for research included identifying which patients would benefit from chemotherapy versus those who could avoid it, as well as determining which patients should receive extended endocrine therapy. She adds that conversations between clinicians and patients regarding treatment decisions have become longer, as the latest data is discussed and therapy is tailored to each case.

In the metastatic setting, as more and more niche trials are underway, researchers are beginning to understand the importance of genomic testing in these patients. Yardley says this holds true in terms of frontline treatment, later lines of therapy, and even for hormone receptor—positive patients. The recently presented SOLAR-1 trial is a perfect example of the role of genomic testing, Yardley adds, which was the first to show benefit in a genomic subgroup of patients with the rare mutation PIK3CA.

Additionally, immunotherapy is starting to make headway in breast cancer. This treatment approach has traditionally lagged in breast cancer compared with other solid tumors, but checkpoint inhibitors are now showing benefit in patients with triple negative disease and those whose tumors express PD-L1.