Oncology Brothers: Practice-Changing Cancer Discussions Early HR+ Disease SABCS 2025 Practice Changing/Informing Highlights: ALTTO, lidERA, NATALEE
Dec 22, 2025
Dr. Laura Huppert, an academic medical oncologist at UCLA, joins to unpack groundbreaking findings from the SABCS 2025 conference on early-stage hormone receptor-positive breast cancer. She delves into the ALTTO study, highlighting the advantage of aromatase inhibitors over tamoxifen. The discussion then moves to the lidERA study, spotlighting the potential of giredestrant in improving invasive disease-free survival. Finally, insights from the NATALEE trial showcase the enduring benefits of ribociclib across various patient subgroups, reshaping treatment strategies.
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Aromatase Inhibitors Outperform Tamoxifen
- In HER2+ HR+ early breast cancer, aromatase inhibitors give better 10-year DFS than tamoxifen based on the ALTTO subanalysis.
- The benefit is pronounced in premenopausal women when combined with ovarian suppression.
Oral SERD Shows Early Adjuvant Benefit
- Giredestrant (oral SERD) improved invasive disease-free survival versus standard endocrine therapy with HR ~0.70 at ~32 months.
- This is the first positive oral SERD adjuvant trial and may change the endocrine therapy backbone.
Anticipate Key Side Effects
- Monitor arthralgia and hot flashes as the top adverse events when choosing between AIs and giredestrant.
- Discuss tolerance expectations with patients since patient-reported outcomes may differ from AE capture.