Understanding the Current Paradigm and New Approaches in the Care of Patients with Hormone Receptor-Positive Breast Cancer — Nursing Symposium Video Proceedings

Faculty

TARGET AUDIENCE
This activity has been designed to meet the educational needs of oncology nurses, nurse practitioners and clinical nurse specialists involved in the treatment of breast cancer.

PURPOSE STATEMENT
By providing information on the latest research developments in the context of expert perspectives, this NCPD activity will assist oncology nurses, nurse practitioners and clinical nurse specialists with the formulation of state-of-the-art clinical management strategies to facilitate optimal care of patients with breast cancer.

LEARNING OBJECTIVES

• Consider available clinical trial findings with CDK4/6 inhibitors for localized hormone receptor (HR)-positive, HER2-negative breast cancer, and identify patients for whom adjuvant treatment with one of these agents may be appropriate.
• Appraise published efficacy and safety data from randomized clinical trials evaluating CDK4/6 inhibitors for HR-positive metastatic breast cancer (mBC) in order to appropriately counsel patients regarding the optimal clinical use of these agents.
• Review available research documenting the correlation between the presence of various biomarkers (eg, PIK3CA/AKT1/PTEN alterations, ESR1 mutations) and response to specific therapies in patients with HR-positive mBC.
• Recall the frequency of phosphoinositide-3 kinase pathway mutations in patients with HR-positive mBC, and recognize the evidence-based approaches available to target these aberrations in individuals with PIK3CA-mutated disease.
• Interrogate published Phase III research documenting the efficacy of AKT inhibitors for progressive HR-positive mBC to determine the current clinical applicability of this approach.
• Understand the mechanism of action of, published and emerging research findings with and the current and future clinical role of oral selective estrogen receptor degraders for patients with HR-positive mBC harboring ESR1 mutations.
• Discern the side effects and toxicities associated with available and investigational endocrine-based therapies for breast cancer, and identify strategies to manage and mitigate them.

ACCREDITATION STATEMENT
Research To Practice (RTP) is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation.

CREDIT DESIGNATION STATEMENT
Video Program: This educational activity for 2.25 contact hours is provided by RTP during the period of May 2025 to May 2026.

This activity is awarded 2.25 ANCC pharmacotherapeutic contact hours.

ONCC/ILNA CERTIFICATION INFORMATION
The program content has been reviewed by the ONCC and is acceptable for recertification points. Learners must apply for NCPD credit to utilize this program for ONCC certification or renewal. To review certification qualifications please visit https://www.researchtopractice.com/Meetings/ONS2025/HRPositiveBreastCancer/ILNA.

ONCC review is only for designating content to be used for ILNA points and is not for NCPD accreditation. NCPD programs must be formally approved for contact hours by an acceptable accreditor/approver of nursing CE to be used for recertification by ONCC. If the NCPD provider fails to obtain formal approval to award contact hours by an acceptable accrediting/approval body, no information related to ONCC recertification or ILNA categories may be used in relation to the program.

PRIVACY POLICY
Personal information and data sharing: Research To Practice aggregates deidentified user data for program-use analysis, program development, activity planning and site improvement. We may provide aggregate and deidentified data to third parties, including commercial supporters. We do not share or sell personally identifiable information to any unaffiliated third parties or commercial supporters. Please see our privacy policy at ResearchToPractice.com/Privacy-Policy for more information.

FOR SUCCESSFUL COMPLETION
Video Program: This NCPD activity consists of a video component. To receive credit, the participant should review the NCPD information, watch the video, complete the post-test with a score of 80% or better and fill out the evaluation located at ResearchToPractice.com/ONS2025/HRPosBC/Video/NCPD.

CONTENT VALIDATION AND DISCLOSURES
Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education and adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of an accredited continuing education activity, including faculty, planners, reviewers and others, are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant financial relationships have been mitigated prior to the commencement of this activity. In addition, all activity content is reviewed by RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

FACULTY — The following faculty reported relevant financial relationships with ineligible entities:

Virginia F Borges, MD, MMSc
Professor of Medicine with Tenure
Robert F and Patricia Young-Connor Endowed Chair in Young Women’s Breast Cancer Research
Deputy Head, Division of Medical Oncology
Director, Breast Cancer Research Program and
Young Women’s Breast Cancer Translational Program
University of Colorado Cancer Center
Aurora, Colorado

Advisory Committees: AstraZeneca Pharmaceuticals LP, Gilead Sciences Inc, Olema Oncology, Pfizer Inc, Seagen Inc; Consulting Agreements: Gilead Sciences Inc, Olema Oncology; Contracted Research: Agendia Inc, AstraZeneca Pharmaceuticals LP, Genentech, a member of the Roche Group, Gilead Sciences Inc, Olema Oncology, Pfizer Inc, Seagen Inc; Data and Safety Monitoring Boards/Committees: Pfizer Inc, Seagen Inc (HER2CLIMB-02 trial); Nonrelevant Financial Relationships: Pearl Scientific LLC.

Jamie Carroll, APRN, MSN, CNP
Assistant Professor, Oncology
Mayo Clinic
Rochester, Minnesota

Advisory Committees: AstraZeneca Pharmaceuticals LP, Lilly, Merck, Novartis; Nonrelevant Financial Relationships: Clinical Care Options, Horizon CME, MJH Life Sciences, OncLive, Scientific Global.

Ronald Stein, JD, MSN, NP-C, AOCNP
Clinical Instructor of Medicine
USC Norris Comprehensive Cancer Center
Los Angeles, California

Advisory Committees: Biotheranostics Inc; Consulting Agreements: AstraZeneca Pharmaceuticals LP.

Seth Wander, MD, PhD
Assistant Professor of Medicine
Harvard Medical School
Attending Physician
Massachusetts General Hospital
Boston, Massachusetts

Advisory Committees: Biovica International AB, Genentech, a member of the Roche Group, Hologic Inc, Pfizer Inc, Puma Biotechnology Inc, Regor Therapeutics Group; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Foundation Medicine, Lilly, Novartis; Contracted Research: Genentech, a member of the Roche Group, Lilly, Nuvation Bio, Pfizer Inc, Regor Therapeutics Group, Sermonix Pharmaceuticals; Data and Safety Monitoring Boards/Committees: Regor Therapeutics Group; Speakers Bureaus: Guardant Health, Lilly; Nonrelevant Financial Relationship: 2nd.MD.

MODERATOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop NCPD activities from the following companies: AbbVie Inc, ADC Therapeutics, Alexion Pharmaceuticals, Amgen Inc, Array BioPharma Inc, a subsidiary of Pfizer Inc, Arvinas, Astellas, AstraZeneca Pharmaceuticals LP, Aveo Pharmaceuticals, Bayer HealthCare Pharmaceuticals, BeiGene Ltd, Black Diamond Therapeutics Inc, Blueprint Medicines, Boehringer Ingelheim Pharmaceuticals Inc, Bristol Myers Squibb, Clovis Oncology, Coherus BioSciences, CTI BioPharma, a Sobi Company, Daiichi Sankyo Inc, Eisai Inc, Elevation Oncology Inc, Exact Sciences Corporation, Exelixis Inc, Genentech, a member of the Roche Group, Genmab US Inc, Geron Corporation, Gilead Sciences Inc, GSK, Hologic Inc, ImmunoGen Inc, Incyte Corporation, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Karyopharm Therapeutics, Kite, A Gilead Company, Legend Biotech, Lilly, MEI Pharma Inc, Merck, Mersana Therapeutics Inc, Mirati Therapeutics Inc, Mural Oncology Inc, Natera Inc, Novartis, Novartis Pharmaceuticals Corporation on behalf of Advanced Accelerator Applications, Novocure Inc, Nuvalent, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Rigel Pharmaceuticals Inc, R-Pharm US, Sanofi, Seagen Inc, Servier Pharmaceuticals LLC, SpringWorks Therapeutics Inc, Stemline Therapeutics Inc, Syndax Pharmaceuticals, Taiho Oncology Inc, Takeda Pharmaceuticals USA Inc, TerSera Therapeutics LLC, and Tesaro, A GSK Company.

RESEARCH TO PRACTICE NCPD PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent reviewers for Research To Practice have no relevant financial relationships to disclose.

These educational activities contain discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

These activities are supported by educational grants from AstraZeneca Pharmaceuticals LP, Genentech, a member of the Roche Group, Novartis, and Stemline Therapeutics Inc.

Release date: May 2025
Expiration date: May 2026

There is no implied or real endorsement of any product by RTP or the American Nurses Credentialing Center.

Dr Borges

Module 1: Role of CDK4/6 Inhibitors in Localized and Metastatic Hormone Receptor (HR)-Positive Breast Cancer

Fasching PA et al. Adjuvant ribociclib (RIB) plus nonsteroidal aromatase inhibitor (NSAI) in patients (Pts) with HR+/HER2− early breast cancer (EBC): 4-year outcomes from the NATALEE trial. ESMO 2024;Abstract LBA13.

Harbeck N et al. Adjuvant abemaciclib plus endocrine therapy for HR+, HER2-, high-risk early breast cancer: Results from a preplanned monarchE overall survival interim analysis, including 5-year efficacy outcomes. ESMO 2023;Abstract LBA17.

Lu Y-S et al. Final results of RIGHT Choice: Ribociclib plus endocrine therapy versus combination chemotherapy in premenopausal women with clinically aggressive hormone receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer. Clin Oncol 2024;42(23):2812-21. Abstract

Rastogi P et al. Adjuvant abemaciclib plus endocrine therapy for hormone receptor-positive, human epidermal growth factor receptor 2-negative, high-risk early breast cancer: Results from a preplanned monarchE overall survival interim analysis, including 5-year efficacy outcomes. J Clin Oncol 2024;42(9):987-93. Abstract

Tarantino P et al. Quantitative standardized high sensitivity (HS)-HER2 testing predicts outcomes with trastuzumab deruxtecan (T-DXd) for metastatic breast cancer (MBC). ESMO 2024;Abstract 394P. Abstract

 

Module 3: Clinical Utility of AKT and PI3K Inhibitors in Progressive HR-Positive mBC

Armaghani AJ, Han HS. Alpelisib in the treatment of breast cancer: A short review on the emerging clinical data. Breast Cancer (Dove Med Press) 2020;12:251-8. Abstract

Borges VF. Options for endocrine-refractory, hormone receptor–positive breast cancer: Which target and when? J Clin Oncol 2021;39(35):3890-6. Abstract

Cerma K et al. Targeting PI3K/AKT/mTOR pathway in breast cancer: From biology to clinical challenges. Biomedicines 2023;11(1):109. Abstract

Schlam I, Chavez-MacGregor M. Best of the year: Advanced breast cancer in 2023. Breast 2024;74:103677. Abstract

Turner NC et al. Capivasertib in hormone receptor-positive advanced breast cancer. N Engl J Med 2023;388(22):2058-70. Abstract

 

Dr Wander

Module 2: PI3K Inhibition as First-Line Treatment for HR-Positive, HER2-Negative Metastatic Breast Cancer (mBC)

André F et al. Alpelisib plus fulvestrant for PIK3CA-mutated, hormone receptor-positive, human epidermal growth factor receptor-2-negative advanced breast cancer: Final overall survival results from SOLAR-1. Ann Oncol 2021;32(2):208-17. Abstract

André F et al. Alpelisib for PIK3CA-mutated, hormone receptor-positive advanced breast cancer. N Engl J Med 2019;380(20):1929-40. Abstract

Brett JO et al. ESR1 mutation as an emerging clinical biomarker in metastatic hormone receptor-positive breast cancer. Breast Cancer Res 2021;23(1):85. Abstract

Jhaveri KL et al. Inavolisib or placebo in combination with palbociclib and fulvestrant in patients with PIK3CA-mutated, hormone receptor-positive, HER2-negative locally advanced or metastatic breast cancer: Phase III INAVO120 primary analysis. San Antonio Breast Cancer Symposium 2023;Abstract GS03-13.

Turner NC et al. Inavolisib-based therapy in PIK3CA-mutated advanced breast cancer. N Engl J Med 2024;391(17):1584-96. Abstract

Turner NC et al. Circulating tumour DNA analysis to direct therapy in advanced breast cancer (plasmaMATCH): A multicentre, multicohort, phase 2a, platform trial. Lancet Oncol 2020;21(10):1296-308. Abstract

Urso L et al. ESR1 gene mutation in hormone receptor-positive HER2-negative metastatic breast cancer patients: Concordance between tumor tissue and circulating tumor DNA analysis. Front Oncol 2021;11:625636. Abstract

Vasan N et al. Concordance between tissue (tumor DNA) and liquid (ctDNA) biopsy next-generation sequencing (NGS) data in detection of PIK3CA, AKT1, and PTEN alterations in breast cancer: A retrospective analysis. ASCO 2024;Abstract e15033.

Vasan N, Cantley LC. At a crossroads: How to translate the roles of PI3K in oncogenic and metabolic signalling into improvements in cancer therapy. Nat Rev Clin Oncol 2022;19(7):471-85. Abstract

 

Module 4: Current and Future Role of Oral Selective Estrogen Receptor Degraders in HR-Positive mBC

Bardia A et al. Elacestrant in ER+, HER2- metastatic breast cancer with ESR1-mutated tumors: Subgroup analyses from the phase III EMERALD trial by prior duration of endocrine therapy plus CDK4/6 inhibitor and in clinical subgroups. Clin Cancer Res 2024;30(19):4299-309. Abstract

Bardia A et al. GS3-01 EMERALD phase 3 trial of elacestrant versus standard of care endocrine therapy in patients with ER+/HER2- metastatic breast cancer: Updated results by duration of prior CDK4/6i in metastatic setting. San Antonio Breast Cancer Symposium 2022;Abstract GS3-01.

Bardia A et al. EMERALD: A randomized, open label, phase III trial to evaluate the efficacy and safety of elacestrant (RAD1901) versus investigator’s choice (IC) of endocrine therapy (ET) for ER+/HER2- advanced breast cancer (BC) following CDK4/6 inhibitor (CDK4/6i) therapy. ASCO 2019;Abstract TPS1104.

Bidard F-C et al. Elacestrant (oral selective estrogen receptor degrader) versus standard endocrine therapy for estrogen receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer: Results from the randomized phase III EMERALD trial. J Clin Oncol 2022;40(28):3246-56. Abstract

Jeselsohn R et al. ESR1 mutations—A mechanism for acquired endocrine resistance in breast cancer. Nat Rev Clin Oncol 2015;12(10):573-83. Abstract

Jhaveri KL et al. Imlunestrant with or without abemaciclib in advanced breast cancer. N Engl J Med 2025;392(12):1189-202. Abstract

Jhaveri KL et al.  Imlunestrant, an oral selective estrogen receptor degrader (SERD), as monotherapy and combined with abemaciclib, for patients w/ ER+, HER2- advanced breast cancer (ABC), pretreated w/ endocrine therapy (ET): Results of the phase 3 EMBER-3 trial. San Antonio Breast Cancer Symposium 2024;Abstract GS1-01.

Oliveira M et al. Camizestrant, a next-generation oral SERD, versus fulvestrant in post-menopausal women with oestrogen receptor-positive, HER2-negative advanced breast cancer (SERENA-2): A multi-dose, open-label, randomised, phase 2 trial. Lancet Oncol 2024;25(11):1424-39. Abstract

Patel R et al. An emerging generation of endocrine therapies in breast cancer: A clinical perspective. NPJ Breast Cancer 2023;9(1):20. Abstract

Turner N et al. Design of SERENA-6, a phase III switching trial of camizestrant in ESR1-mutant breast cancer during first-line treatment. Future Oncol 2023;19(8):559-73. Abstract