In this conference update video, Profs. Michael Gnant and Giuseppe Curigliano provide key insights from the highly anticipated 19th St. Gallen Breast Cancer Conference (SGBCC) Satellite Symposium, sponsored by Menarini Stemline. 

Key topics included: 

• Defining recurrence risk in high- vs low-risk groups 
• Review of current treatment guidelines 
• Ongoing clinical trials evaluating oral SERDs in the adjuvant early breast cancer setting 

Clinical takeaways

• Risk assessment enables personalized treatment approaches, optimizing therapeutic outcomes 
• High-risk patients exhibit significantly lower invasive disease-free survival than intermediate/low-risk groups, underscoring the need for enhanced treatment strategies
• Adjuvant ET intensification with CDK4/6 inhibitors has shown clinical benefit; however, emerging resistance remains a challenge, contributing to disease recurrence
• Oral SERDs have shown evidence of superior efficacy over SOC in metastatic settings, particularly in the presence of ESR1-mut and are now being explored in early-stage disease as either an upfront or switch treatment strategy  
• Elacestrant is the only oral SERD with agonistic properties being investigated as a switch strategy in a “pure high-risk population” following demonstration of CCCA rate reduction, substantial Ki-67 suppression, and activity in ESR1 wild-type breast cancer