Foreword
In order to allow Chinese clinical oncologists to share world-class scientific research faster and more conveniently Results, on July 1-2, 2022, the Chinese Society of Clinical Oncology (CSCO) and the Beijing Heathco Clinical Oncology Research Foundation co-hosted the “2022 China Clinical Oncology Annual Progress Symposium (BOC) and Best of ASCO® 2022 China”. During the meeting, Yimaitong specially invited Professor Yin Yongmei from the Maternal and Child Branch of Jiangsu Provincial People’s Hospital to share the latest progress and prospects in the field of breast cancer.
Expert Profile
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Professor Yin Yongmei
Chief Physician and Doctoral Supervisor
Vice President, Maternal and Child Branch, Jiangsu Provincial People’s Hospital
Chinese Society of Clinical Oncology (CSCO) Vice President
Vice President of Beijing Sisco Clinical Oncology Foundation
Vice Chairman of CSCO Breast Cancer Expert Committee
Member of the Standing Committee of Breast Cancer Professional Committee of China Anti-Cancer Association p>
CSCO Patient Education Expert Committee Chair-designate
Yimaitong: With the deepening of the research on the heterogeneity of breast tumors, the expression of HER2 is low The introduction of this transformative concept breaks the definition of “either yang or yin” for HER2. The DESTINY-Breast04 study was announced at the ASCO Plenary Session. Could you please talk about the significance of this study?
Professor Yin Yongmei
>Jiangsu Provincial People’s Hospital Maternity and Children Branch
In the past, the pathological definition of HER2 was “either positive or negative”. (2021 edition)” guidelines, the concept of “low HER2 expression” has been proposed for pathological diagnosis, and “immunohistochemistry (IHC) 2+ and FISH negative, or IHC 1+” is defined as low HER2 expression. At this year’s ASCO conference, the DESTINY-Breast04 study attracted much attention. The results of the study suggest that for patients with inoperable, metastatic, HER2-low expressing breast cancer, T-DXd has demonstrated superiority compared with physician-chosen treatment options. The superior curative effect provides better treatment options for breast cancer patients with low HER2 expression. In the future, I believe that the DESTINY-Breast04 study may bring about changes in clinical practice. In addition, the pathology community is also very concerned about this study. Due to the possible temporal and spatial heterogeneity of HER2 in primary and metastatic lesions, the Research may also bring about changes in the pathological diagnosis of HER2. We also hope that the pathological diagnosis can be more accurate and standardized, and ADC drugs can be better used in clinical practice.
Yimaitong: The DESTINY-Breast04 study will provide new insights into breast cancer with low HER2 expression What changes will clinical practice bring? What are the future research directions?
Professor Yin Yongmei
>Jiangsu Provincial People’s Hospital Maternity and Children Branch
Clinically, endocrine therapy and chemotherapy are often selected for patients with advanced breast cancer with low expression of HR+/HER2, while those with low expression of HR-/HER2 are often selected for endocrine therapy and chemotherapy. Breast cancer patients are often classified as triple-negative breast cancer in the past. With the concept of low HER2 expression and the development of treatment methods, we have ADCs targeting low HER2 expression, so patients with low HER2 expression are not equivalent to patients with pure triple-negative breast cancer, and their follow-up treatment options are not only Chemotherapy or immunotherapy are available. In the future, with the progress of the Breast series of studies, ADC drugs may move from the back-line treatment to the front-line. In addition, except for late stageResearch, the early postoperative adjuvant phase, and the neoadjuvant phase of research are also being carried out, which is worth looking forward to.
Yimaitong: As T-DXd just mentioned, the ADC’s Research and development has entered the fast lane. This type of drug is likened to a “precision missile” against tumors. It can identify tumor cells and avoid normal cells, which is conducive to precise treatment and improves treatment efficiency. Could you please talk about what other research in this field deserves attention at this year’s ASCO annual meeting? What opportunities and challenges will it bring to breast cancer clinical practice?
Professor Yin Yongmei
>Jiangsu Provincial People’s Hospital Maternity and Children Branch
In recent years, new ADC drugs have been poured into clinical research and clinical practice. At this year’s ASCO and BOC/BOA conferences, the TROPiCS-02 study was noteworthy, which showed that 2-4 patients who were hormone receptor (HR) positive and HER2 negative after progression on a CDK4/6 inhibitor For patients undergoing first-line chemotherapy, the Trop-2 ADC drug Sacituzumab govitecan (SG) showed superior efficacy compared with the treatment regimen selected by the physician. This study provides later-line treatment opportunities and options for HR+/HER2- breast cancer patients after progression on CDK4/6 inhibitors. In addition, SG has been approved for marketing in the field of triple-negative breast cancer treatment, and the release of the results of the TROPiCS-02 study further expands the user population of SG.
Yimaitong: Endocrine therapy is essential for HR-positive breast cancer patients. Research on various drugs such as CDK4/6 inhibitors is in full swing. Could you please talk about the research that deserves attention at this ASCO meeting in the field of endocrine therapy? What hope will it bring to the clinical practice of HR-positive breast cancer?
Professor Yin Yongmei
>Jiangsu Provincial People’s Hospital Maternal and Child Branch
About 60%-70% of HR-positive patients with breast cancer. In the advanced stage, for patients who are sensitive to endocrine therapy, we will adopt the principle of giving priority to endocrine therapy. In the past, for people who progressed after treatment with CDK4/6 inhibitors, subsequent treatment options have become a difficult problem for us. The MAINTAIN study showed that for patients with HR+/HER2- metastatic breast cancer who have progressed on CDK4/6 inhibitor therapy, compared with switching endocrine therapy, switching endocrine therapy and receiving ribociclib therapy have better benefits. The results of this study suggest that cross-line CDK4/6 inhibitors can be used as a follow-up treatment option for this population. Based on the TROPiCS-02 study and the MAINTAIN study, after the ASCO conference, the NCCN guidelines were updated very quickly on the post-progression part of HR+/HER2- breast cancer CDK4/6 inhibitors. Clinical practice recommendations for different levels of evidence. I believe that the announcement and update of the major research results of this ASCO conference will have a positive significance for the update of the CSCO BC guidelines next year.
Editor: Uni
Reviewer: Prof. Yin Yongmei
Typesetting: Uni
Execution: XY
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