SUMMARY
As a yearly tradition, the annual San Antonio Breast Cancer Symposium provided us with important updates regarding the systemic treatment approaches of breast cancer. In the early breast cancer landscape, probably the most awaited data release at SABCS 2024 was the primary analysis of GeparDouze investigating atezolizumab in early triple-negative breast cancer. In the advanced breast cancer, results from EMBER-3 investigating imlunestrant as a single agent and in combination with abemaciclib were eagerly awaited. In addition, the PATINA trial provided an unexpected late-breaking abstract reporting on the addition of palbociclib to maintenance treatment with endocrine and anti-HER2 therapy in advanced hormone receptor positive/HER2-positive breast cancer. Next to many systemic therapy updates, important data has been presented on local therapy for breast cancer and will be discussed in another issue, mostly focusing on de-escalation concepts such as surgery deferral for ductal carcinoma in situ, abstinence of sentinel lymph node procedure in low-risk disease or postmastectomy radiotherapy in pN0/pN1 disease. On the intersection between radiotherapy and systemic therapy, the innovative EUROPA trial reported an early interim analysis of a study investigating either radiotherapy or endocrine therapy as a single modality for stage 1 hormone receptor positive, HER2-negative breast cancer in patients aged ≥70 years.2 Without ipsilateral breast tumour recurrences (IBTR) at the data cut-off, further follow-up is required for comparative efficacy analysis as defined by five-year IBTR. However, the presented co-primary endpoint of health-related quality-of-life at two years showed a significant reduction in quality-of-life associated with endocrine therapy compared to baseline and to patients receiving only radiation therapy during the first two years of treatment, with at least 22.5% of patients requiring a switch of endocrine therapy and 12.4% discontinuing endocrine therapy during the follow-up. These data are very encouraging and can gradually be implemented in clinical practice in selection based on life expectancy, patient preference and further study follow-up. Below, we summarise the most important data releases regarding systemic breast cancer treatment presented at SABCS 2024.
(BELG J MED ONCOL 2025;19(3):129–136)
