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ASCO 2023: Highlights and Other Notable Updates

By BCRF | July 21, 2023

BCRF on the biggest breast cancer news from the American Society of Clinical Oncology’s annual meeting this year

A record 43,000 oncologists, researchers, patient advocates, and industry representatives attended the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting—one of the field’s most important conferences. BCRF team members attended this year’s meeting along with BCRF investigators, who took home top awards, presented new findings, and participated in panels and symposia.

Below, we summarize key updates in breast cancer and link to more in-depth BCRF coverage of the meeting.

BCRF investigator serves term as ASCO president

For the last year, BCRF investigator and Scientific Advisory Board member Dr. Eric Winer has served as the 59th president of ASCO—a voluntary position that’s considered a tremendous honor in the field.

Dr. Winer’s deeply moving and personal presidential address opened the meeting and tied in with his presidential theme: “Partnering With Patients: The Cornerstone of Clinical Care and Research.”

Dr. Winer spoke at length about his own experience as a patient, beginning when he was diagnosed with hemophilia at birth. Chronicling his years of treatment and how it influenced his decision to become a doctor, Dr. Winer connected his story to the theme of his ASCO presidency, sharing five lessons for improving the physician-patient relationship with those in the room.

“We may have different struggles, but we all face adversity and can learn and grow from it,” he said in his lecture. “We all have a lived experience that we can draw upon and is relevant to the work that we do as oncologists. Our own narratives can help us form better partnerships.”

Watch or read Dr. Winer’s presidential address here

Updates from breast cancer clinical trials

Among the major breast cancer clinical trials presented at ASCO this year, there was a notable focus on CDK4/6 inhibitors and antibody-drug conjugates (ADCs), along with a few other practice-changing results:

  • NATALEE: Study findings indicated that combining the CDK4/6 inhibitor ribociclib (Kisqali®) with endocrine therapy significantly reduced patients’ risk of breast cancer recurrence.
  • SONIA: No significant difference was seen in time to disease progression, overall survival, or quality of life with CDK4/6 inhibitors used as first-line treatments compared to second-line. First-line use of the inhibitors means prolonged exposure, increased toxicity, and costs to patients—all important considerations when making treatment decisions.
  • X-7/7: This trial showed that a new treatment schedule (seven days on, seven days off) for the oral chemotherapy capecitabine/Xeloda® resulted in similar efficacy compared to the standard of care but was better tolerated with significantly fewer side effects such as hand-foot syndrome and diarrhea. This has positive implications for patients that may need capecitabine maintenance over the long-term.
  • CAPItello-291: BCRF investigator Dr. Hope Rugo presented current findings that showed the addition of capivasertib—the first AKT inhibitor likely to be approved by the FDA—to the selective estrogen degrader fulvestrant improved progression-free survival in trial participants and with manageable side effects.
  • DESTINY-Breast trials pooled analysis: BCRF investigator Dr. Ian Krop presented an age-specific analysis of data pooled from the DESTINY-Breast01,02, 03 clinical trials. The study showed that the efficacy of trastuzumab deruxtecan (T-DXd/Enhertu®) in patients 65 and older treated for metastatic HER2-positive breast cancer was generally similar compared to patients younger than 65, with slightly increased toxicity.
  • TROPiCS-02: Trial investigators, including Dr. Rugo, reported the final overall survival analysis showed that sacituzumab govitecan (Trodelvy®) provides clinically meaningful benefit over standard-of-care chemotherapy and is a safe and effective treatment option for people with metastatic HR-positive/HER2-negative breast cancer, who currently have limited treatment options.
  • A promising HER3 ADC: Researchers reported that the HER3-directed ADC patritumab-DXd showed promise in the patient population tested and had a manageable safety profile. Investigators anticipate that these studies will support the introduction of patritumab-DXd for treating people with all types of metastatic breast cancer.
  • Sequential ADCs for treating breast cancer: A team including BCRF investigator Dr. Neelima Vidula conducted a retrospective study to examine how patients responded to one ADC after another. Initial results provided new insights into the best order for ADC-based treatment options.

Read more about these trials and others presented at ASCO here

Dr. Bernard Fisher symposium highlights research on immune response

At ASCO’s annual meetings, BCRF supports the Dr. Bernard Fisher Memorial Annual Clinical Science Symposium—named in honor of the late researcher who revolutionized breast cancer care through rigorous clinical trials. This year’s symposium was chaired by Dr. Ana Garrido-Castro of the Dana-Farber Cancer Institute and focused on harnessing the immune response in breast cancer.

BCRF investigators Drs. Kim Blenman and Sherene Loi served as discussion leaders for four presentations given by Drs. Florentine Hilbers (Netherlands Cancer Institute), Daniel Stover (The Ohio State University), Hanna Huebner (University Hospital Erlangen), and Amy Sanders Clark (University Of Pennsylvania).

Among the symposium’s highlights were presentations on stromal tumor infiltrating lymphocytes (sTILs) as a potential important biomarker in metastatic breast cancer. Dr. Hilbers provided updates on the BCRF-supported AURORA projects, the largest global effort to improve our understanding of metastatic breast cancer. She and her team are characterizing the microenvironment of lesions in primary and metastatic breast cancer and have thus far found that sTILs were decreased in metastatic lesions compared to primary tumors, depending on where they were in the body.

Researchers also noted that in triple-negative breast cancer, high sTILs were associated with longer overall survival, and that artificial intelligence and machine learning tools may improve TILs scoring for this promising new direction in metastasis research.

BCRF study evaluates impact of weight loss in breast cancer patients

Obesity is associated with a higher risk of recurrence and death after a breast cancer diagnosis—making research to further understand this link and devise interventions critical.

Dr. Jennifer Ligibel of the Dana-Farber Cancer Institute presented the latest results from the phase 3 BCRF-supported Breast Cancer Weight Loss (BWEL) clinical trial assessing the impact of a telephone-based weight loss intervention on invasive disease-free survival. The study involved patients with overweight and obesity (as measured by a BMI of 27 or greater) who were diagnosed with stage 2 or 3 hormone receptor (HR)-positive/HER2-negative breast cancer or triple-negative breast cancer.

Dr. Ligibel’s research team observed that trial participants lost 4.8 percent of their body weight after six months and maintained this loss at 12 months compared to the control group. Now that the investigators have proven the telephone-based intervention was effective, they will continue to measure the impact of weight loss intervention on invasive disease–free survival and other outcomes through follow-up with trial participants.

Two BCRF researchers receive top awards

As in years past, BCRF investigators were among those honored with special awards at this year’s meeting for their impact on cancer research. For his pioneering basic research, Dr. Alan Ashworth received the Science of Oncology Award, and Dr. Angela DeMichele took home the Gianni Bonadonna Breast Cancer Award for work to change how the disease is treated and diagnosed.

Drs. Ashworth and DeMichele were invited to give award lectures at ASCO this year, and both stressed the importance of collaboration and team science throughout their careers.

Additionally, four BCRF investigators became ASCO fellow distinctions, and Dr. Monica Bertagnolli, former BCRF investigator and current National Cancer Institute director, received the Lichter Visionary Leader Award—another prestigious honor.

Read BCRF’s coverage of these awards here