Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

ALTERNATE trial: No fulvestrant benefit in locally advanced ER+ HER2– breast cancer

Key clinical point: Fulvestrant with or without anastrozole provided no ESDR benefit over anastrozole alone as neoadjuvant endocrine therapy in postmenopausal women with locally advanced ER+ HER2– BC.

Major finding: ESDRs with fulvestrant, fulvestrant + anastrozole, and anastrozole alone: 22.7%, 20.5%, and 18.6%.

Study details: The phase 3 ALTERNATE trial of 1,299 patients.

Disclosures: The ALTERNATE trial is funded by the Alliance Foundation, NCI Biomarker, Imaging and Quality of Life Studies Funding Program, Breast Cancer Research Foundation, Genentech,and AstraZeneca. Dr. Ma reported consulting or advisory roles with a variety of pharmaceutical companies, and research funding from pharmaceutical companies to her institution. Dr. Wolff reported relationships (consulting or advisory roles and research funding) with Ionis, Biomarin, Celldex, and patents or royalties (issued or pending) associated with methylation in breast cancer.


Ma C et al. ASCO 2020, Abstract 504.