Topics:
Breast Cancer • Medical Oncology • NCI-CCC Tumor Board Question • University of Iowa • HR+ • NCI-CCC Breast Tumor Board Question • Breast Cancer, Non-metastatic
Would you still obtain Ki-67 prior to use of adjuvant abemaciclib in a patient who has otherwise met MonarchE treatment criteria, such as 1-3 positive LNs, grade 3 and/or tumor >5 cm?
Patient is pre-menopausal and has cT3cN1, grade 2, ER positive, Her 2 negative IDC. Metastatic disease to axillary LNs was biopsy-proven. Patient was given neoadjuvant ddAC-T with excellent response (ypT1cN0(i+)) post-lumpectomy. Would their response to neoadjuvant chemotherapy affect your decision?
Answer from: Medical Oncologist at Academic Institution
In the setting of a patient with residual disease after NAT with an initial grade 3 stage IIIA ER positive breast cancer, I would treat with adjuvant abemaciclib regardless of Ki67 status if the absolute risk of recurrence was high enough. pCR rates after NAT for ER positive breast cancer are low, a...
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