Newly approved targeted therapies for patients with advanced hormone
receptor (HR)-positive, HER2-negative breast cancer are changing care. “We
have an abundance of opportunities, but challenges with having to choose
the right opportunity at the right time,” says Robert A. Figlin, MD, the Steven
Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer
Center in Los Angeles. Dr. Figlin discusses how to navigate new options with
Manali Bhave, MD, a breast medical oncologist and assistant professor at the
Emory University School of Medicine in Atlanta. Dr. Bhave stresses that
disease progression in breast cancer can’t be addressed with a one-size-fits-
all option. “Where do we go from here? I think it is largely dependent on
clinical factors, patient comorbidities, and even biomarker status,” she
explains. Dr. Bhave and Dr. Figlin discuss recent developments in targeted
therapies and important challenges. “We’ve come a long way in treating
metastatic HR-positive, HER2-negative breast cancer as more of a chronic
disease,” she says.

Dr. Bhave reported consulting fees from Lilly, Novartis, and AstraZeneca.

Dr. Figlin reported various financial relationships.

Data on the use of durvalumab after chemoradiotherapy transformed the standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC). “This is a real practice-changing observation from the PACIFIC trial,” said Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles. He recently spoke with Meghan Mooradian, MD, an instructor at Harvard Medical School in Boston, about her team’s recent research assessing the protocol established by the PACIFIC study. “We really are hoping for a cure,” she said in describing how she makes decisions related to the timing of durvalumab after chemoradiotherapy. Dr. Mooradian also addressed toxicity concerns and shared what she sees as lingering questions related to disease progression. “What should we really be using next?” she asked.

Dr. Mooradian reported consulting or advisory roles with AstraZeneca, the Bristol Myers Squibb
Foundation, Istari Oncology, Regeneron, and Xilio Therapeutics; and other relationships with Aptitude Health, Curio Science, DAVA Oncology, and OncLive/MJH Life Sciences.

Dr. Figlin reported various financial relationships.

Results of the phase 3 LAURA clinical trial, presented at the 2024 American Society of Clinical Oncology Annual Meeting, showed that osimertinib significantly improves progression-free survival in patients with unresectable stage III EGFR-mutant non-small cell lung cancer (NSCLC) after chemoradiotherapy. “The benefits of osimertinib in this patient population when compared to placebo are just incredibly dramatic,” noted Robert A. Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at the Cedars-Sinai Cancer Center in Los Angeles. He spoke with lead study author Suresh S. Ramalingam, MD, the Roberto C. Goizueta Distinguished Chair for Cancer Research and the executive director at the Winship Cancer Institute of Emory University in Atlanta, about how oncologists should adjust their practice in the wake of these key findings. Dr. Ramalingam tackled questions about the optimal duration of osimertinib therapy, toxicity concerns, and notable benefits seen in the LAURA data. “Osimertinib reduced both intrathoracic progression and extrathoracic progression, particularly intracranial progression,” he noted.

Dr. Ramalingam reported research funding from Amgen, AstraZeneca/MedImmune, Bristol Myers Squibb, Merck, Pfizer, and Takeda; travel, accommodations, and other expenses from AbbVie; and a relationship with the American Cancer Society.

Dr. Figlin reported various financial relationships.