Topics:
Breast Cancer • Medical Oncology • MD Anderson • NCI-CCC Tumor Board Question • NCI-CCC Breast Tumor Board Question • Breast Cancer, Non-metastatic
Would you offer adjuvant abemaciclib plus endocrine therapy for favorable histology ER+/PR+/HER2-negative tumors such as pure tubular, mucinous, cribriform, or papillary that otherwise meet MonarchE trial criteria?
MonarchE trial criteria includes "patients with four or more positive nodes, or one to three nodes and either tumor size ≥ 5 cm, histologic grade 3, or central Ki-67 ≥ 20%"
Answer from: Medical Oncologist at Academic Institution
These pure subtypes are rare (<5%) and many pathology studies state that the term should be reserved for cases where at least 90% of the tumor is tubular or mucinous with low grade features to be considered favorable. In one retrospective study for over 100 G1 pure tubulars, only 5% had N1 diseas...
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Answer from: Medical Oncologist at Community Practice
I would discuss it with the patient. Abemaciclib is not easy to tolerate and I would counsel them on the potential side effects. But yes, I would offer it to the patient since patients irrespective of histology/Ki67 were included in the monarchE trial if they had several positive LNs/larger tumor si...