Module 1: Evolving Paradigms in the Management of ER-Positive Metastatic Breast Cancer (mBC)

DISCUSSION TOPICS

• Clinical and biologic factors under consideration when designing a therapeutic plan for patients with ER-positive mBC: prior treatment exposure, disease-free interval, age, menopausal status, symptomatology, location and extent of metastases
• Published research data with and current clinical role of CDK4/6 inhibitors in premenopausal, postmenopausal and elderly patients with ER-positive mBC
• Similarities and differences among commercially available CDK4/6 inhibitors; incidence, monitoring and treatment of commonly occurring toxicities in patients receiving CDK4/6 inhibitors
• Optimal management of disease progressing on CDK4/6 inhibitors in combination with hormonal therapy
• Incidence and clinical implications of PI3 kinase mutations in patients with progressive ER-positive mBC; available efficacy and safety findings with the alpha-specific PI3K inhibitor alpelisib with fulvestrant for postmenopausal patients with ER-positive, HER2-negative advanced BC with PIK3CA mutations and disease progression on or after an aromatase inhibitor with or without a CDK4/6 inhibitor
• Incorporating everolimus into the treatment algorithm for patients with ER-positive mBC
• Counseling patients receiving oral therapies regarding adherence

Module 2: New Agents and Emerging Strategies for HER2-Negative mBC

DISCUSSION TOPICS

• Clinical trial results supporting the recent FDA approval of atezolizumab in combination with nab paclitaxel for unresectable locally advanced or metastatic PD-L1-positive triple-negative BC
• Mechanisms underlying immune-related adverse events associated with anti-PD-1/PD-L1 antibody therapy
• Optimal monitoring of patients receiving anti-PD-1/PD-L1 antibodies for the presence of immune-mediated adverse events; supportive care protocols and indications for withholding or permanently discontinuing therapy
• Ongoing Phase III studies evaluating anti-PD-1/PD-L1 antibodies alone or in combination with other systemic therapies for localized, locally advanced and metastatic breast cancer
• Indications for BRCA mutation testing in patients with BC; implications of a BRCA1/2 germline mutation for prognosis and current therapeutic selection
• Data sets supporting the FDA approvals of olaparib and talazoparib for patients with mBC and a BRCA germline mutation
• Recognition and management of common PARP inhibitor-associated adverse events

Module 3: Recently Approved and Investigational Approaches for Localized and Advanced HER2-Positive Disease

DISCUSSION TOPICS

• Indications for neoadjuvant systemic therapy and selection of optimal approach
• FDA approval of and patient selection for pertuzumab as a component of adjuvant treatment; indications for the use of adjuvant pertuzumab in patients receiving it as a component of neoadjuvant therapy
• Key efficacy and safety results with adjuvant T-DM1 for patients with HER2-positive primary BC with residual disease after preoperative therapy
• Patient selection for postadjuvant neratinib and factors guiding its use in clinical practice
• Common side effects observed with neratinib; potential strategies to mitigate associated gastrointestinal toxicity
• Clinical factors (eg, age, performance status, sites of disease, symptomatology, prior adjuvant therapy) influencing the sequencing of anti-HER2 agents in the metastatic setting; integration of T-DM1 into the treatment algorithm
• Efficacy and safety of neratinib/capecitabine for patients with HER2-positive BC and brain metastases
• Mechanisms of action of, early activity and safety data with and ongoing evaluation of novel HER2-directed therapies (eg, tucatinib, margetuximab, trastuzumab deruxtecan)