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Carmen Criscitiello: Breaking news in Metastatic Breast Cancer
Nov 5, 2024, 15:32

Carmen Criscitiello: Breaking news in Metastatic Breast Cancer

Carmen Criscitiello, Medical Oncologist at IEO and Associate Professor at University of Milan, posted on X:

Breaking news in Metastatic Breast Cancer (MBC)!  In just the past few days, two pivotal trials (SERENA-2 and INAVO120) offer fresh insights on targeted approaches in MBC. These findings could reshape clinical decisions and boost outcomes.

SERENA-2: Camizestrant, an oral SERD, shows strong PFS benefit over fulvestrant, especially in patients with ESR1 mutations—similar to earlier data with elacestrant (EMERALD trial). Camizestrant brings new hope but isn’t the first oral SERD to show results.

INAVO120: In patients with PIK3CA-mutated, HR+/HER2- MBC, inavolisib + palbociclib + fulvestrant nearly doubles PFS vs. standard treatment. Notably, patients with early recurrence, a particularly challenging population with poor prognosis.

Updated NGS Applicability: ESMO‘s prior recommendations on NGS for MBC now gain even more clinical relevance. These studies suggest a clearer pathway for when and how to leverage mutation data (ESR1, PIK3CA) in guiding therapeutic choices.

NGS—Tissue or Plasma? Deciding between tissue or plasma-based NGS is crucial. Each has strengths: plasma (ctDNA) offers less invasive sampling and can reveal dynamic changes, while tissue analysis might give more comprehensive mutation profiles.

Takeaway: SERENA-2 and INAVO120 trials underscore the role of early molecular profiling with NGS in tailoring therapy for ER+/HER2- MBC. Molecular profiling isn’t just future-focused; it’s now a core part of decision-making.”