Oncology Brothers: Practice-Changing Cancer Discussions SABCS 2024 Highlights - INSEMA, KEYNOTE-522, OlympiA
Jan 9, 2025
In this discussion, Dr. Laura Huppert, a medical oncologist from UCSF, highlights key trials from SABCS 2024. She explores the INSEMA study's potential reduction of axillary surgery for early-stage hormone receptor-positive breast cancer, which could enhance patient quality of life. The conversation shifts to KEYNOTE-522, revealing the latest on Pembrolizumab and promising biomarkers for triple-negative breast cancer. Lastly, the OlympiA study shows significant gains in survival for BRCA-positive patients with Olaparib. Expert insights and practical takeaways abound!
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Omitting Sentinel Node Didn’t Worsen 6-Year IDFS
- The INSEMA trial found no significant difference in 6-year invasive disease-free survival when omitting sentinel lymph node biopsy in selected early HR+ patients.
- Patients who skipped axillary surgery had fewer complications, less lymphedema, and better quality of life.
Discuss Omission Carefully With Patients
- Discuss omission of sentinel lymph node biopsy only for highly selected low-risk patients and counsel about limited long-term follow-up.
- Explain potential missed node positivity that could affect adjuvant CDK4/6 inhibitor decisions.
Results Limited To HR+/HER2– Population
- INSEMA enrolled only hormone receptor positive, HER2-negative patients aged mainly 50 and older with lower-risk tumors.
- The results should not be generalized to HER2-positive or triple-negative subtypes where nodal status drives therapy.