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.”
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