Shaping the Future of Breast Cancer Care With Oral SERDs, Genomic Testing, and ctDNA: Rebecca Chacko, MD

Rebecca Chacko, MD, a breast medical oncologist at Henry Ford, discussed emerging therapeutic strategies for patients with breast cancer and highlighted the excitement surrounding new oral selective estrogen receptor degraders (SERDs), in an interview with The American Journal of Managed Care^®. She emphasized the significant impact of genomic testing in refining neoadjuvant and adjuvant therapy decisions, providing patients with clearer guidance.

Chacko served as a panelist at the Detroit Institute for Value-Based Medicine (IVBM) on the session titled "Evolving Breast Cancer Care: Addressing Unmet Needs Across the Patient Journey, highlighting common gaps in patient care. She expressed optimism about the future role of tumor-informed circulating tumor DNA (ctDNA) testing in surveillance, anticipating its ability to detect early cancer recurrence and enable timely adjustments to treatment strategies.

This transcript was lightly edited; captions were auto-generated.

Transcript

How do you think the development of new oral selective estrogen receptor degraders (SERDs) will impact approaches to endocrine-sensitive breast cancer, particularly in the metastatic setting or for patients with ESR1 mutations?

I think the class of SERDs is exciting for patients. I think the different trials that are going on that are exploring whether or not the utility is limited to patients who have an ESR1 mutation or not are also exciting because it would definitely open up more therapeutic options for patients who progress on first line treatments, or who come with an ESR1 mutation or not. I do think it is an exciting part and an exciting pathway for our patients, but I think that there's also more that we need to know in terms of who is going to be super responders to these treatments and who may not respond to those drugs. We need to look at other opportunities for treatments in them.

What do you find to be the most exciting emerging therapeutic strategies in breast cancer that you anticipate will significantly impact patient care in the next 5 to 10 years?

I think the use of genomic testing is really helpful in making decisions about neoadjuvant therapy or adjuvant therapy, which is something that we have been using for a while, but getting more refined testing and clearer answers really gives patients more confidence in what their ultimate plan is. Also, surveillance using ctDNA testing that is tumor informed I think is an exciting path. It's new. It's not necessarily something that is being utilized by everyone just yet, but I think with time, we'll see whether or not this is beneficial for our patients, and if we can hopefully detect early cancer recurrence and be able to switch strategies, rather than waiting for patients to deteriorate and then missing windows of opportunity for treatment. I definitely think that genomic testing, ctDNA, all of these tools will help us help patients enjoy their life and live longer.