2021 Year in Review - HER2-Negative Breast Cancer

Abemaciclib plus nonsteroidal aromatase inhibitors were shown to be a successful initial treatment in a Japanese subpopulation, with a tolerable safety profile, consistent with findings in the whole population in treating patients with HR-positive, HER2-negative advanced breast cancer.
The therapeutic advantage of alpelisib over fulvestrant in the treatment of patients with HR-positive, HER2-negative breast cancer and other malignancies is further enhanced by a matched/weighted analysis comparing BYLieve with the real-world scenario.
Endocrine therapy used in combination with CDK4/6 inhibitors, in particular, have transformed the metastatic breast cancer landscape, promisingly improving progression-free survival and overall survival among patients with HR-positive, HER2-negative metastatic breast cancer.
Neoadjuvant chemotherapy is becoming more popular for patients with locally advanced breast cancer. Downstaging may result in a smaller surgical extent or a higher breast conservation rate, and a better cosmetic outcome. Chemotherapy, on the other hand, has both short- and long-term complications.
Treatment with ICIs in metastatic TNBC has shown encouraging results. Immunotherapy has shifted the paradigm of cancer treatment and opened new research opportunities. TNBC is characterized by immunologic activation while being the most common subtype of breast cancer.
Along with surgery, radiation, chemotherapy, and targeted therapy, immunotherapy has emerged as the fifth pillar of cancer treatment and is revolutionizing cancer treatment across the board.
Sacituzumab govitecan is an effective new medication for people with metastatic TNBC that is well-tolerated. The most prevalent side effects seen in individuals with metastatic TNBC using sacituzumab govitecan are similar to those seen with chemotherapy and can be managed with early, proactive intervention.
SASCIA was a phase 3 trial evaluating sacituzumab govitecan, an antibody–drug conjugate that received accelerated approval from the FDA in 2020 for the treatment of patients with metastatic TNBC who have received ≥2 previous therapies for metastatic disease.
In October 2021, trastuzumab deruxtecan was granted Breakthrough Therapy Designation by the FDA in the United States for the treatment of adult patients with unresectable or metastatic HER2-positive breast cancer who have received ≥1 previous anti-HER2–based regimens.
Two new antibody–drug conjugates with a topoisomerase I inhibitor payload have recently been added to the therapy options for patients with metastatic TNBC and HER2-positive breast cancer.
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