Hossam Abdulkhalek, Divisional Clinical Director of Cancer and Clinical Services at Western Health and Social Care Trust, shared a post on LinkedIn:
“The presentation today by Luca Malorni offers a compelling snapshot of estrogen receptor (ER) loss during metastatic progression in breast cancer, drawing on robust datasets from MSK 2018 and the ESME national cohort.
It underscores a clinically significant phenomenon: the discordance in hormone receptor status between primary and metastatic sites, which affects therapeutic decision-making and prognostic stratification.
Key highlights include:
- ER loss occurs in approximately 14–15% of HER2-negative metastatic breast cancer cases.
- Discordance in receptor status is observed in 16% of matched primary–metastatic pairs, with implications for treatment adaptation.
- Genomic profiling reveals distinct mutational landscapes across ER status groups, notably higher TP53 and RB1 mutations in ER-/- cases and ESR1 mutations in ER+/- cases.
This reinforces the importance of re-biopsy at metastatic diagnosis and the need for dynamic biomarker assessment to guide precision oncology.
Areas for enhancement:
- Clinical Implications: While mutational differences are well presented, the downstream impact on treatment choices (e.g., endocrine resistance, chemotherapy selection) could be more explicitly discussed.
- Temporal Dynamics: Explore whether ER loss correlates with time to metastasis or prior lines of therapy.
- Biopsy Barriers: Low biopsy rates in inaccessible lesions (10%) – a deeper dive into strategies to overcome this (e.g., liquid biopsy, imaging-guided techniques) would be valuable.”
More posts featuring Hossam Abdulkhalek.
