Abstract P1-11-10: Current Endocrine/Systemic Treatment Landscape of ER+ HER2 negative early-stage Breast Cancer: First Data from the RESCUE trial

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Abstract Background: RESCUE is a prospective, international, multicenter health care study on risk assessment by the clinicomolecular test EndoPredict® and long-term patient outcome in early luminal breast cancer. For patients (pt) with early luminal breast cancer, precise national and international guidelines on (neo)adjuvant systemic therapy exist. Nevertheless, especially regarding endocrine therapies, treatment landscape has been shown to be heterogeneous in real world. Objective: By analyzing baseline and follow up data from RESCUE, we describe the current (neo)adjuvant treatment landscape for pt with ER+ HER2neg early-stage breast cancer including: type of endocrine agents used, addition of GnRH analogs (GnRHAa)/ovarian function suppression (OFS) to ET in premenopausal pt, use of chemotherapy and use of bone modifying agents (Bisphoshonates or Denosumab) in the adjuvant setting. Methods: Data from pt, who entered the RESCUE trial between July 2018 and September 2022 at 45 (42 German/3 Swiss) breast centers were collected via electronic case report forms. Pt were eligible, if they had been diagnosed with HR+/HER2- primary invasive breast cancer stage I/II, T1 to T3 with 0 to 3 positive lymph nodes and if they had an EndoPredict®-test within six months before inclusion. Results: 1143 pt were analyzed. Median age was 57,0 years (range26,0-82,0). 614 pt(53,7%) were classified as pN0. Tumor-Grading was reported as follows: G1 (137pt, 12,0%), G2 (893pt, 78,1%), G3 (111pt, 9,7%). Distribution of Ki-67 was recorded as follows: £10% (228pt, 20,0%), 11-24% (162pt, 14,2%), 325% (753pt,65,9%). Of the 1134 female pt, 394 were premenopausal and 734 postmenopausal. Systemic treatment recommendations given by the centers´ documented tumor board decisions were as follows: 62,9% (n=248) of premenopausal pt and 61,0% (n=448) of postmenopausal pt were recommended to undergo (neo)adjuvant Chemotherapy (CTX). In the premenopausal cohort, the choice of ET recommendation included an GnRHa/OFS in 14,5% of cases (57pt). In these 57 pt, GnRHa/OFS was recommended to be combined with an aromatase inhibitor as initial ET in 15 cases (3,8% of premenopausal pt) and with tamoxifen in 41 cases (10,4% of premenopausal pt). 47 pt (82,5%) of the 57 pt with GnRHa/OFS-recommendation and 183 pt (54,3%) of the 337 pt without GnRHa/OFS-recommendation were recommended to undergo (neo)adjuvant CTX. Bone modifying agents (Bisphosphonates or Denosumab) were recommended in 10,2% of premenopausal and 32,7% postmenopausal pt. Follow up data on actually received ET (including +/- GnRH) and CTX (including +/- anthracyclines) will be presented in detail. Conclusion: These real world data show that in spite of existing guideline recommendations for the use of GnRHa/OFS in premenopausal women with early luminal breast cancer at higher risk for relapse, this is not routinely implemented. Therefore, regarding the ET recommendation, this patient cohort might be undertreated. Follow up data on actually received ET (including +/- GnRH) and CTX (including +/- anthracyclines) will be presented in detail. Sponsor: The study is sponsored by the North-Eastern-German Society of Gynecological Oncology (NOGGO) e.V. Citation Format: Johannes Ettl, Evelyn Klein, Christine Heinz, Ji Young Kim, Jens-Uwe Blohmer, Carsten Denkert, Stefan Paepke, Christine Mau, Katja Gnausch, Jasmin Yamamoto, Sven-Thomas Graßhoff, Tilmann Lantzsch, Cornelia Meisel, Kay Friedrichs, Andreas Schnelzer, Stephan Seitz, Axel Gatzweiler, Sirrka Kluge, Markus Borner, Pamela Lammert, Anke Kleine-Tebbe, Anja Pelzl, Dorothea Fischer, Amelie Bletscher, Christian Schindlbeck, Carmen Schade-Brittinger, Michael Wittenberg, Marion Kiechle. Current Endocrine/Systemic Treatment Landscape of ER+ HER2 negative early-stage Breast Cancer: First Data from the RESCUE trial [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P1-11-10.

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