Expert Point of View: George Sledge, MD

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George Sledge, MD

We saw a striking relationship between HRD score and pathologic complete response.

—George Sledge, MD

George Sledge, MD, Professor, and Chief, Division of Oncology, Stanford University Medical Center, told The ASCO Post that he found the data from the pooled analysis “very exciting.”

“One of the big questions in triple-negative breast cancer is how to select which drugs work best for which patients. We know that platinum agents are active, but not for all patients. We know that BRCA mutations are potentially good markers for who will benefit from DNA-damaging agents, but most patients don’t have BRCA mutations,” he noted. “Finding a signal that would allow us to select patients for treatment would obviously be very useful.”

A Word of Caution

He said the strength of this study is that it “brought together researchers who have been doing this work across the world but with smaller numbers of patients.” In the pooled analysis, all patients had a platinum backbone, all were evaluated for HRD status, and all had long-term follow-up, he pointed out.

“We saw a striking relationship between HRD score and pathologic complete response,” Dr. Sledge said, but offered a word of caution: “This is a compilation of patients.” What is needed next, he suggested, is a larger, prospective, and “definitive” trial to prove that homologous recombination deficiency is a biomarker for response to platinum. “This will give us a clean-kill answer.” ■

Disclosure: Dr. Sledge reported no potential conflicts of interest.


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