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Survival in advanced hormone receptor (HR)-positive breast cancer did not improve with the addition of a histone deacetylase (HDAC) inhibitor to standard endocrine therapy, according to a randomized trial.
Median progression-free survival (PFS) improved from 3.1 to 3.3 months and median overall survival (OS) from 21.7 to 23.4 months among patients who received entinostat plus the aromatase inhibitor (AI) exemestane. Neither difference reached statistical significance, despite a significant increase in lysine acetylation, which correlated in improved PFS in an earlier trial of the HDAC inhibitor.
"The short median progression-free survival and low overall response rate observed with an endocrine therapy backbone suggests that improved decision-making tools are required to help determine who may need chemotherapy versus alternative strategies in this setting," reported Roisin M. Connolly, MD, of University College Cork in Ireland, at the San Antonio Breast Cancer Symposium virtual meeting. "Pharmacogenomic analysis confirmed target inhibition in entinostat-treated patients."