Rapid Fire Session 2: Mini-Oral Presentations
Thursday, December 7 • 12:00 p.m. – 12:45 p.m. • Hall 1

Presentation: A Multicenter, Phase I/II Trial of Anastrozole, Palbociclib, Trastuzumab, and Pertuzumab in Hormone Receptor (HR)-Positive, HER2-Positive Metastatic Breast Cancer (ASPIRE)

Amy Tiersten, MD
Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute,
New York, New York

What is your presentation about?
This is a chemotherapy-free front-line regimen for triple positive metastatic breast cancer that showed excellent results.

What makes this topic important in 2023?
The chemo-free nature of the regimen and the use of a CDK 4/6 inhibitor in HER2 positive disease.

How did you get involved in this particular area of breast cancer research, care, or advocacy?
Targeted therapy for metastatic breast cancer and avoiding chemotherapy if possible is a long-standing interest of mine. Achieving excellent results for patients with good quality of life is an important goal.

Presentation: A phase III study comparing trastuzumab emtansine with trastuzumab, pertuzumab, and docetaxel in older patients with metastatic HER2-positive breast cancer. (JCOG1607 HERB TEA study)

Akihiko Shimomura, MD, PhD
National Center for Global Health and Medicine,
Tokyo, Japan

What is your presentation about?
This study is a phase III study comparing trastuzumab emtansine with trastuzumab, pertuzumab, and docetaxel in older patients with metastatic HER2-positive breast cancer. The eligibility criteria were as follows: age 65 years and older, HER2-positive metastatic breast cancer, no previous systemic treatment with chemotherapy and anti-HER2 targeted drugs, ECOG PS 0–2 for 65–74 years or 0–1 for 75 years or older, and adequate organ function. Treatment consisted of T-DM1 every 3 weeks or HPD every 3 weeks after a 1:1 ratio randomization. The primary endpoint was overall survival (OS). The trial was discontinued after the first interim analysis. T-DM1 was not non-inferior to HPD (HR: 1.263; 95%CI 0.677-2.357, One-sided p-value: 0.95322) in terms of OS. Grade 3 or more non-hematological adverse events were less common and lower in the T-DM1 arm (35.2%) than in the HPD arm (58.6%). T-DM1 was not non-inferior to HPD in terms of OS. However, T-DM1 showed better tolerability in terms of frequency and severity of adverse events. HPD will continue to be the standard of care as the first-line treatment for older patients with HER2-positive metastatic breast cancer.

What makes this topic important in 2023?
This study revealed that HPD is still the standard 1st line treatment for older patients with HER2-positive metastatic breast cancer. However, T-DM1 showed the lower frequency and severity of adverse events.