T. Feys MBA, MSc

Highlights of the 23rd annual meeting of the Belgian Society of Medical Oncology (BSMO)

SUMMARY

As always, the annual meeting of the Belgian Society of Medical Oncology (BSMO) wanted to provide a platform for the dissemination of practice-changing information relevant to Oncology within Belgium. In light of the ongoing global pandemic, the 23^rd annual meeting went virtual in 2021. This did not detract from the engaging line up of presentations, with a particular emphasis on treatment breakthroughs in a variety of cancers. In addition to this, several projects with a local impact on the Belgian Oncology landscape were presented. Get up to date with the 2021 BSMO 23^rd annual meeting with these highlights.

BELG J MED ONCOL 2021;15(3):134-44

Highlights in HER2-positive breast cancer

In the field of Human Epidermal Growth Factor Receptor 2 (HER2) positive early breast cancer, an interesting Subpopulation Treatment Effect Pattern Plot (STEPP) analysis of the APHINITY trial was presented at SABCS 2020. In addition, BluePrint RNA sequencing was used in an attempt to predict the benefit of adjuvant pertuzumab in this trial. Other interesting data in early HER2-positive breast cancer came from the use of neratinib as extended adjuvant therapy. In the metastatic setting, results of the PERTAIN study, the first randomised phase II trial to assess the addition of pertuzumab to trastuzumab and an aromatase inhibitor in the presence or absence of induction chemotherapy, were presented. Finally, a long list of abstracts featured results with novel HER2-directed therapies, including the antibody-drug conjugate trastuzumab deruxtecan, the tyrosine kinase inhibitor tucatinib and the investigational monoclonal antibody margetuximab.

Highlights in luminal breast cancer

Among patients with early breast cancer (BC), approximately 75% present with a luminal tumour (HR+).¹ In addition to being the most common BC subtype, luminal BC also causes most deaths.² Interestingly, the deaths caused by this BC subtype occur over a longer period of time compared to what is seen with HER2-positive and triple negative breast cancer (TNBC).^3,4 As such, it is safe to say that luminal BC continues to be an unmet clinical need. To address this need, a long list of clinical trials are looking into novel strategies to optimize the management of patents with luminal BC. SABCS 2020 featured a plethora of abstracts discussing updates of pivotal trials in luminal breast cancer in addition to studies generating promising results with novel therapeutic agents in patients with more advanced HR+ BC.

Highlights in triple-negative breast cancer

Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer that is prone to early recurrence. In recent years, however, promising data were generated with immunotherapy-based treatment regimens in both the neoadjuvant and metastatic setting. Several updates of these studies were presented at SABCS 2020. In addition, the meeting featured several interesting abstracts discussing potential biomarkers that would facilitate a better treatment selection. In addition to immunotherapy, several novel therapeutics, including antibody-drug conjugates and targeted therapies are emerging in the treatment for patients with metastatic TNBC.

Highlights in radiotherapy

SABCS 2020 featured several interesting presentations in the field of radiotherapy. The PRIME 2 study investigated the impact of omitting postoperative whole breast radiotherapy in older, low-risk women with early invasive breast cancer. Outcomes of the phase III BIG 3-07/TROG 07.01 trial were also reported providing improved insights into the optimal radiation dose and fractionation schedule for non-low risk ductal carcinoma in situ of the breast. Other interesting topics included the comparison of patient and physician reports of toxicity after breast radiotherapy and the finding that radiation therapy improves survival in early-stage HER2-positive breast cancer with a high-levels of tumour infiltrating lymphocytes. Finally, we report on the results of a retrospective analysis assessing the feasibility of radiation therapy de-escalation in patients with stage I, node-negative, HER2-positive breast cancer.

Miscellaneous news from SABCS 2020

We want you to be completely up to date on the results presented at SABCS 2020, hence this article will focus on three presentations that were not previously addressed in the congress highlights. A first presentation reported on the high rate of persistent controlled substance use following mastectomy with reconstruction surgery. Results of a large systematic review and meta-analysis provide solid evidence on the chance of pregnancy after breast cancer and underscores the importance of oncofertility counselling. A third interesting study performed a large, pooled analysis to further define and explore the role of circulating tumor cell count as a tool for early treatment monitoring in patients with metastatic breast cancer (MBC).