At this SGBCC(18th St. Gallen International Breast Cancer Conference 2023, 15-18 March,Vienna),We were very glad to interview Professor Nadia Harbeck, from Department of Gynecology and Obstetrics, Comprehensive Cancer Center of the Ludwig-Maximilians-University, Munich, Germany. She shared with us her views on chemotherapy in ER+/HER2- early breast cancer patient wiht low genomic/high clinical risk.
Oncology Frontier: Thank you for your time, and just now the topic of debate you participant was in the early breast cancer, do we need chemotherapy in low genomic/high clinical risk (ER+/HER2-)? Could you share your opinions?
Nadia Harbeck：Yes, in the debate the question was low genomic risk, high clinical risk narrowed down to 0-3 involved lymph nodes, luminal breast cancer, do we need chemotherapy? And my answer was definitely not.
First of all, we have a lot of data that in the low genomic risk tumors, patients don't respond well to chemotherapy.
And second, I think for those populations, where particularly in the young women, we would favor chemotherapy based on those data alone. With the German ADAPT study, we have another solution because we not only do oncotype, but we also test for endocrine sensitivity, and if we give four weeks of endocrine therapy before surgery, and the patients have a good endocrine response. We know that in ADAPT trial the distant disease free survival is 97% at five years. So there is no reason to give these women in chemotherapy.
And whether we can also use this approach for larger tumors or more involved lymph nodes with a low genomic risk and good endocrine response by adding CDK4/6 inhibitor, for example, to an endocrine therapy we're currently evaluating in the ADAPT trial we randomizing endocrine base versus chemotherapy in that approach. So maybe at the next st.Gallen meeting I can already tell you some results of this study.