Benjamin Walbaum
Photo from Benjamin Walbaum/X

Benjamin Walbaum: Can Next-Generation Oral SERDs Improve Outcomes Over Standard Adjuvant Endocrine Therapy?

Benjamin Walbaum, Medical Oncologist at Pontifical Catholic University of Chile, shared a post on LinkedIn:

“It was a pleasure to share my perspective on ER-positive early breast cancer as part of SABCS25, highlighting one of the most important studies presented this year: the LIDERA trial.

Can next-generation oral SERDs improve outcomes over standard adjuvant endocrine therapy?

LIDERA is a global phase III trial comparing giredestrant with standard endocrine therapy in intermediate- and high-risk ER+/HER2- early breast cancer, including a clinically relevant population:

  • ~80% previously treated with chemotherapy
  • ~40% premenopausal
  • ~12% stage I disease

Key takeaways:

  • Improved invasive disease-free survival, with a 2.8% absolute benefit at ~3 years
  • Reduction in distant recurrences (~2.3% absolute benefit)
  • Magnitude of benefit comparable to early signals seen with adjuvant CDK4/6 inhibitors
  • Similar overall toxicity to standard endocrine therapy, with fewer discontinuations due to musculoskeletal symptoms

Beyond LIDERA, ctDNA-based analyses also featured prominently at SABCS that could help us better tailor our treatment strategies:

  •  PALLAS ctDNA analysis confirmed ctDNA as a strong prognostic marker, but showed no impact of palbociclib on ctDNA clearance
  • The phase II LEADER trial suggested higher ctDNA clearance with ribociclib, supporting a potential effect on micrometastatic disease

Overall, these data reflect a rapidly evolving adjuvant landscape—bringing new endocrine options, raising important questions about treatment escalation, biomarker-guided selection, and cost-effectiveness, and challenging us to better personalize therapy for each patient.”

More posts featuring Benjamin Walbaum.