Dr. Susan Galbraith

you really have a very good effect compared with the rheumatism in improving the time to progression.

So the idea is that in a more endocrine sensitive population in the wild type, you will have a bigger effect, but also you will prevent the emergence of ESR1 mutations in the patient population that are being treated in first line.

Both of those things together should lead to an improvement in the outcome for patients in that first line set up.

Well, it's a key escape mechanism from the signaling you get with the oestrogen receptor.

So the patients that have got this, you know, this biggest segment of breast cancer, the 70% of breast cancer that is hormone receptor positive, the key driver of proliferation is the signaling downstream of the oestrogen receptor.

So a more effective inhibition of that will lead to less recurrence of disease.

That's fundamentally why it matters.

And in the adjuvant setting, over decades now, we've shown that if you can give a hormonal treatment of breast cancer that is more effective on reducing that proliferation,

it leads to improvements in disease-free survival and the risk of recurrent disease.

And that leads to improved in the cure rate.

That was shown with tamoxifen.

It's been shown with the aromatase inhibitors.

You're now seeing it with the addition of the CDK4-6 inhibitors.

And the best predictor of outcome in the adjuvant settings

is this reduction in the proliferation marker, Ki-67, in a window of opportunity study.

And that's built off the data from the poetic study that was done years ago.

What we've shown with Serena 3 in this window of opportunity study is a robust inhibition of Ki-67 at a well-tolerated dose of camisestrin.

And that's what predicts for the potential for good outcomes in the two groups.

adjuvant studies that we've got Cambria 1 and Cambria 2 in that adjuvant filter.

So I think the first thing is if you think about the situation from a patient perspective in triple negative breast cancer, these women who are often young women with this metastatic triple negative breast cancer have the poorest prognosis out of any of those segments of breast cancer that we've got with less than a 15% chance of a five-year survival and no improvement in overall survival in over a decade.