Seock-Ah Im
Led MONALEESA-7, which proved a CDK4/6 inhibitor extends survival in premenopausal breast cancer, and steers Korea's breast cancer trial network.
Seock-Ah Im is a principal investigator across the ribociclib, palbociclib, and ADC programmes in breast cancer and led MONALEESA-7, the first trial to show an overall survival benefit for CDK4/6 inhibition in premenopausal women.
| Title | Journal | Year |
|---|---|---|
| Overall survival with ribociclib plus endocrine therapy in breast cancer (MONALEESA-7) | NEJM | 2019 |
Patients with hormone-receptor-positive metastatic breast cancer that has stopped responding to endocrine therapy can be offered trastuzumab deruxtecan as their first chemotherapy-type treatment if the tumour shows any HER2 staining, rather than waiting until after conventional chemotherapy. Whether to use it before or after chemotherapy is now a choice, since overall survival was not shown to differ and the drug carries a risk of lung inflammation.
Ribociclib is a second adjuvant CDK4/6 option, and the only one with data in node-negative stage II disease. Roughly 3 in 100 patients avoid a relapse or death at three years, so the decision depends heavily on individual risk, tolerance of a three-year oral drug, and cost. Whether the benefit persists after treatment ends, as it did with abemaciclib, needs longer follow-up.
For hormone-receptor-positive metastatic breast cancer that has already had chemotherapy, Dato-DXd controls the disease for longer with fewer severe side effects than chemotherapy, but does not help patients live longer, so it is not a standard option here. The result is a reminder that progression-free survival is a surrogate; regulators and clinicians should wait for survival data before adopting an ADC in a setting where later therapies are effective.
For HER2-positive metastatic breast cancer that has progressed after trastuzumab and a taxane, trastuzumab deruxtecan is now the standard second-line treatment and T-DM1 has moved later in the sequence. The benefit is large enough that ADC design, not just the target, is understood to be what matters. Patients need lung monitoring because of the risk of pneumonitis.
Patients whose breast cancer was previously called HER2-negative may now be eligible for an effective HER2-directed drug if their tumour has even low-level HER2 staining, so pathology reports must now distinguish HER2-low (1+ or 2+/ISH-negative) from HER2-zero. This applies to metastatic disease after at least one line of chemotherapy; it does not mean these patients benefit from trastuzumab or other older HER2 drugs.
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not linked directly; found by shared links- PersonDebu Tripathy
Shares Ribociclib, CDK4/6, Estrogen receptor (ERα), Triple-negative breast cancer (TNBC).
- PersonYeon Hee Park
Shares DESTINY-Breast03: trastuzumab deruxtecan beats T-DM1 as second-line treatment of HER2-positive metastatic breast cancer, DESTINY-Breast04: trastuzumab deruxtecan works in HER2-low breast cancer, creating a new treatable group, Palbociclib, CDK4/6.
- TrialMONALEESA-2
Shares Ribociclib, CDK4/6, Estrogen receptor (ERα), HR-positive / HER2-negative breast cancer.
- PersonDennis J. Slamon
Shares Ribociclib, NATALEE: three years of ribociclib after surgery in a broad population of hormone-receptor-positive early breast cancer, Palbociclib, CDK4/6.
- PersonBinghe Xu
Shares NATALEE: three years of ribociclib after surgery in a broad population of hormone-receptor-positive early breast cancer, TROPION-Breast01: datopotamab deruxtecan versus chemotherapy in pretreated hormone-receptor-positive breast cancer, and why a PFS win did not translate to survival, DESTINY-Breast03: trastuzumab deruxtecan beats T-DM1 as second-line treatment of HER2-positive metastatic breast cancer, DESTINY-Breast04: trastuzumab deruxtecan works in HER2-low breast cancer, creating a new treatable group.
- PersonAngela DeMichele
Shares Palbociclib, CDK4/6, Triple-negative breast cancer (TNBC), HR-positive / HER2-negative breast cancer.
- IdeaCDK4-selective inhibitors as the new first-line backbone
Shares Ribociclib, Palbociclib, CDK4/6, HR-positive / HER2-negative breast cancer.
- PersonCarlos Barrios
Shares NATALEE: three years of ribociclib after surgery in a broad population of hormone-receptor-positive early breast cancer, TROPION-Breast01: datopotamab deruxtecan versus chemotherapy in pretreated hormone-receptor-positive breast cancer, and why a PFS win did not translate to survival, DESTINY-Breast06: trastuzumab deruxtecan before any chemotherapy in hormone-receptor-positive, HER2-low or ultralow breast cancer, HR-positive / HER2-negative breast cancer.