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Solid Tumors
Breast Cancer
Issues in Oncology
Health-Care Policy

Health-Care Access Unlikely to Explain Racial/Ethnic Disparities in Breast Cancer Outcomes

Even with equivalent access to care, black patients with breast cancer may fare worse than white patients with breast cancer, according to Lawrence H. Kushi, ScD, Director of Scientific Policy at the Kaiser Permanente Northern California Division of Research in Oakland. “Accounting for...

Solid Tumors
Breast Cancer

Gene-Expression Assays in Early-Stage Breast Cancer: Who Should Order Them and When?

A deeper understanding of biology has allowed significant advances in the treatment of breast cancer. In the early-stage setting, standard pathology measures can help identify which subset of patients with hormone receptor–positive breast cancers are more likely to experience benefit from...

Solid Tumors
Breast Cancer

Genomic Profiling With Multidisciplinary Collaboration: Improving Breast Cancer Outcomes Through Timely Chemotherapy Initiation

As reviewed in this issue of The ASCO Post, Losk and colleagues from Dana-Farber/Brigham and Women’s Cancer Center report their institution’s implementation of a protocol of surgeon-initiated genomic profiling of estrogen receptor–positive tumors in women with early breast cancer that resulted in ...

Solid Tumors
Breast Cancer

Surgeon-Initiated Gene-Expression Profile Testing in Early-Stage Breast Cancer Reduces Time to Start of Chemotherapy

In a single-center study reported in the Journal of Oncology Practice, Katya Losk, MPH, of Dana-Farber Cancer Institute, and colleagues found that an intervention including surgeon initiation of gene-expression profile testing with Oncotype DX significantly reduced the time to testing, receipt of...

breast cancer

Long-Term Risk of Breast Cancer Recurrence After 5 Years of Endocrine Therapy

In a meta-analysis reported in The New England Journal of Medicine by Pan et al for the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), it was found that breast cancer recurs at a steady incidence following cessation of adjuvant endocrine therapy after 5 years, with the risk...

Solid Tumors
Breast Cancer

About One in Four Women With Small Breast Tumors May Benefit From Chemotherapy

A large subset analysis of the MINDACT trial suggests that oncologists may be undertreating women with small (< 1 cm) node-negative breast tumors, which are clinically considered to be low risk but can be genomically high risk. About one in four women with small node-negative breast tumors <...

breast cancer

Antidepressant for Aromatase Inhibitor–Associated Arthralgia in Early-Stage Breast Cancer

The phase III SWOG S1202 trial has shown benefit of the antidepressant agent duloxetine in reducing aromatase inhibitor–associated joint pain in women with early-stage breast cancer. These results were reported in the Journal of Clinical Oncology by Henry et al. Study Details In the...

Solid Tumors
Breast Cancer

Pathologic Complete Response Rates Not Improved With Neoadjuvant Letrozole/Palbociclib

As neoadjuvant treatment of women with high-risk luminal breast cancer, the combination of letrozole and palbociclib (Ibrance) did not reduce the residual cancer burden or improve the rates of breast-conserving surgery, in the phase II UNICANCER- NeoPAL study presented at the 2017 European Society ...

Solid Tumors
Breast Cancer

Neratinib for Extended Adjuvant Treatment of Early-Stage HER2-Positive Breast Cancer

On July 17, 2017, neratinib (Nerlynx) a dual inhibitor of HER2 and epidermal growth factor receptor (EGFR), was approved for extended adjuvant treatment of adults with early-stage HER2-overexpressed/amplified breast cancer following adjuvant trastuzumab (Herceptin)-based therapy.1,2 Supporting...

Solid Tumors
Breast Cancer

Abemaciclib in Hormone Receptor–Positive, HER2-Negative Breast Cancer

On September 28, 2017, the cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitor abemaciclib (Verzenio) was approved for use in combination with fulvestrant (Faslodex) for women with hormone receptor–positive, HER2-negative advanced or metastatic breast cancer with disease progression following...

Breast Cancer

Computer-Based Support May Allow Physicians to Spend More Time on ‘Human Aspects of Cancer Care’

As computer-based physician support systems for decision-making in cancer management continue to evolve, “we will come to embrace this as something that liberates us to spend more time on the human aspects of cancer care,” Andrew D. Seidman, MD, told participants at the 2017 Lynn Sage Breast Cancer ...

Breast Cancer

What Can We Do Differently for Premenopausal Patients With Breast Cancer?

While age remains a major risk factor for breast cancer, with nearly 80% of new cases occurring in women aged 50 years and older, women diagnosed at a younger age generally have poorer outcomes. This is partly because premenopausal women are more likely to have triple-negative breast cancer, which ...

Solid Tumors
Breast Cancer

Where Are We Now in Triple-Negative Breast Cancer?

The treatment of triple-negative breast cancer is rapidly evolving, as clinical trials continue to test chemotherapy agents and combinations and immunotherapy studies promise potentially “game-changing” interventions early in the course of disease, Joyce O’Shaughnessy, MD, reported at the 19th...

Solid Tumors
Breast Cancer

Gauging the Impact of Weight Loss Intervention on Breast Cancer Outcomes

“Growing research suggests that body weight is not only related to the risk of developing malignancy, but also prognosis after diagnosis, especially in breast cancer,” said Jennifer A. Ligibel, MD, of Dana-Farber Cancer Institute and Harvard Medical School, at the 19th Annual Lynn Sage Breast...

breast cancer

5-Year Outcomes With Extended Adjuvant Therapy in HER2-Positive Breast Cancer

The 5-year analysis of the phase III ExteNET trial has shown that 1 year of neratinib (Nerlynx) after trastuzumab (Herceptin)-based adjuvant therapy significantly improved invasive disease–free survival vs placebo in HER2-positive breast cancer. These findings were reported in The Lancet...

breast cancer

Are African American Women With Type 2 Diabetes at Increased Risk for ER-Negative Breast Cancer?

A prospective study by Palmer et al assessing the relationship of type 2 diabetes and the incidence of estrogen receptor–negative and estrogen receptor–positive breast cancer among African American women has found statistically significant evidence of an increased risk of estrogen...

breast cancer

FDA Approves Fulvestrant in Combination With Abemaciclib in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

Today, the U.S. Food and Drug Administration (FDA) approved a new indication for fulvestrant (Faslodex), expanding the drug's approved use to include combined therapy with abemaciclib (Verzenio), a cyclin-dependent kinase (CDK) 4/6 inhibitor, for the treatment of hormone receptor–positive,...

Breast Cancer

Predisposition to Breast Cancer due to Mutations Other Than BRCA1/BRCA2 in Ashkenazi Jewish Women

A cohort study in Ashkenazi Jewish women with breast cancer identified mutations other than BRCA1 and BRCA2 founder alleles that were associated with cancer risk. These results were reported by Walsh et al in JAMA Oncology. Among Ashkenazi Jewish women, three mutations in BRCA1 and BRCA2...

Breast Cancer

Ovarian Function Recovery During Anastrozole Therapy in Postmenopausal Patients With Breast Cancer

In the phase III DATA trial reported in the Journal of the National Cancer Institute by Vivianne C.G. Tjan-Heijnen, MD, PhD, of the Maastricht University Medical Centre, the Netherlands, and colleagues, 12% of women with breast cancer who had chemotherapy-induced ovarian function failure...

Breast Cancer

10-Year Follow-up on Adjuvant Therapy in Postmenopausal Early Breast Cancer

The 10-year follow-up of the phase III TEAM trial has shown that exemestane alone and sequential tamoxifen/exemestane provide similar outcomes as adjuvant endocrine therapy in postmenopausal women with hormone receptor–positive early breast cancer. The findings were reported in The Lancet Oncology ...

Breast Cancer

BRCA1/2 Status in Response to Therapy in Triple-Negative Breast Cancer

An analysis of the GeparSixto trial in triple-negative breast cancer showed that adding carboplatin to neoadjuvant therapy improved pathologic complete response rate in patients without BRCA1/2 mutation and that response rates were higher overall in those with mutations, without additive effects...

breast cancer

Higher Risk of Breast Cancer Does Not Motivate Cancer Screening in Many Women

Some women, because of genetic predisposition, personal, or family history, have a higher-than-average lifetime risk of developing breast cancer. For those women, earlier magnetic resonance imaging (MRI) is recommended for cancer screening. But according to new findings presented at the American...

breast cancer

Long-Term Follow-up of Cardiac Function After Adjuvant Therapy With Trastuzumab in Early Breast Cancer

As reported by Ganz et al in the Journal of Clinical Oncology, long-term follow-up of patients in the National Surgical Adjuvant Breast and Bowel Project (NSABP) Protocol B-31/NRG Oncology trial showed no worsening of cardiac function or quality of life with the addition of adjuvant trastuzumab...

Solid Tumors
Breast Cancer

Twisted Pink Joins Forces With the Conquer Cancer Foundation to Support Metastatic Breast Cancer Research

As one of the few organizations exclusively focused on funding research for metastatic breast cancer, Twisted Pink has a unique story to tell. Based in Louisville, Kentucky, the organization was founded in 2014 by breast cancer survivor Caroline Johnson. While Ms. Johnson fully recovered from her...

Breast Cancer
Gynecologic Cancers

More Data From ESMO 2017

In GEICAM 2006-10, the addition of fulvestrant at 250 mg/d to anastrozole did not improve 5-year disease-free survival over anastrozole alone (91.0% vs 90.8%).  “Immune induction” with chemotherapy or radiotherapy appeared to enhance response to nivolumab in women with metastatic triple-negative...

Breast Cancer
Gynecologic Cancers

International Trials Reveal New Findings in the Management of Breast and Ovarian Cancers

The European Society for Medical Oncology (ESMO) 2017 Congress, held in Madrid, featured important news including at least seven practice-changing or potentially practice-changing trials, which are covered in recent issues of The ASCO Post. Here we present additional highlights of studies in breast ...

Breast Cancer

Model Emphasizes Long-Term Risks of Ovarian Ablation Plus Aromatase Inhibitor

“At Microphone 1” is an occasional column written by Steven E. Vogl, MD, of Bronx, New York. When he’s not in his clinic, Dr. Vogl can generally be found at major oncology meetings and often at the microphone, where he stands ready with critical questions for presenters of new data. Here Dr. Vogl...

breast cancer

Complications and Patient Satisfaction After Breast Reconstruction in Women Receiving Radiotherapy

In a prospective cohort study reported by Jagsi et al in the Journal of the National Cancer Institute, autologous reconstruction was associated with fewer complications and greater patient satisfaction vs implant approaches in women receiving postmastectomy radiotherapy. Study Details The...

breast cancer

ASCO/CCO Focused Guideline Update on Role of Bone-Modifying Agents in Metastatic Breast Cancer

As reported by Catherine Van Poznak, MD, of the University of Michigan, Ann Arbor, and colleagues in the Journal of Clinical Oncology, ASCO and Cancer Care Ontario (CCO) have collaborated in providing a focused update for the ASCO clinical practice guideline on the role of bone-modifying agents in...

breast cancer

ASHG 2017: Quantifying Breast Cancer Risk Based on Rare Variants and Background Risk

Rare variants combined with background genetic risk factors may account for many unexplained cases of familial breast cancer, and knowing the specific genes involved could inform choice of prevention and treatment strategies, according to findings presented in a plenary session at the American...

breast cancer

Potential Risk Activities and Breast Cancer–Related Lymphedema in Patients Undergoing Bilateral Surgery

In a study reported in the Journal of Clinical Oncology, Asdourian et al found that several factors considered to pose an increased risk of lymphedema were not significantly associated with the occurrence of lymphedema among women undergoing bilateral breast cancer surgery. Study Details In the...

breast cancer

Extended Aromatase Inhibitor Therapy After Sequential Endocrine Therapy

In the Dutch phase III DATA trial reported in The Lancet Oncology by Tjan-Heinjen et al, a nonsignificant disease-free survival advantage was found for 6 vs 3 years of adjuvant aromatase inhibitor therapy after 2 to 3 years of tamoxifen in hormone receptor–positive early breast cancer....

breast cancer

FDA Grants Priority Review for Olaparib in Metastatic Breast Cancer

On October 18, AstraZeneca and Merck & Co announced that the U.S. Food and Drug Administration (FDA) has accepted and granted Priority Review to a supplemental New Drug Application (sNDA) for the use of olaparib (Lynparza) tablets in patients with germline BRCA-mutated, HER2-negative...

breast cancer

MAF Amplification and Outcomes With Adjuvant Zoledronic Acid in Early Breast Cancer

An analysis from the phase III AZURE trial has shown that MAF-negative status was associated with a benefit and MAF-positive status, with a detriment of adjuvant zoledronic acid in early breast cancer. The analysis was reported by Coleman et al in The Lancet Oncology. Study Details The current...

Solid Tumors
Breast Cancer

Breast Cancer Has Changed Me, But the Change Has Been Positive

I’ve always had dense breasts and avoided doing breast self-exams because I couldn’t tell if the lumpiness I was feeling was something serious or merely normal fibrous tissue. Instead I relied on my yearly mammogram to spot any early signs of cancer. Four years ago, I was once again relieved to...

Solid Tumors
Breast Cancer

Stalked by BRCA1: A Women Struggles to Survive the Same Disease That Killed Her Mother

No matter what a person does in life, for good and bad, his or her inherited genetic makeup follows along the way. Such was the case with British journalist Sarah Gabriel, who inherited the BRCA1 mutation from her mother, who died of ovarian cancer when Ms. Gabriel was in college. Much of her...

breast cancer

Long-Term Use of Long-Acting Insulin Analogs and Breast Cancer Risk in Type 2 Diabetes

A study in the UK population has shown that long-term use of the long-acting insulin glargine was associated with increased risk of breast cancer among women with type 2 diabetes. The findings were reported by Wu et al in the Journal of Clinical Oncology. Study Details The study involved a...

breast cancer

FDA Grants Priority Review for Abemaciclib as Initial Treatment of Advanced Breast Cancer

On October 12, Eli Lilly and Company announced that the U.S. Food and Drug Administration (FDA) granted Priority Review designation to its New Drug Application (NDA) for abemaciclib (Verzenio), a cyclin-dependent kinase (CDK) 4/6 inhibitor. MONARCH 3 The NDA was based upon the positive interim...

breast cancer

Relationship Between Targeted HER2 Therapy and Breast Reconstruction

Trastuzumab (Herceptin) therapy for breast cancers that express the HER2 protein does not increase the risk of complications at the surgical site in women who undergo immediate breast reconstruction after mastectomy, according to findings published by Shammas et al in the Journal of the American...

breast cancer

Initial Treatment With CDK4/6 Inhibitor and Aromatase Inhibitor for Advanced Breast Cancer

As reported in the Journal of Clinical Oncology by Goetz et al, an interim analysis in the phase III MONARCH 3 trial has shown a significant progression-free survival benefit with the addition of the cyclin-dependent kinase (CDK) 4/6 inhibitor abemaciclib (Verzenio) to a nonsteroidal aromatase...

breast cancer
symptom management

Cryotherapy for Preventing Chemotherapy-Induced Peripheral Neuropathy in Patients With Breast Cancer

A self-controlled clinical trial by Hanai et al investigating the efficacy of cryotherapy for the prevention of chemotherapy-induced peripheral neuropathy in patients with breast cancer treated with paclitaxel has found that cryotherapy resulted in a clinically and statistically significant...

Issues in Oncology
Breast Cancer

Treating Breast Cancer During Pregnancy Calls for Careful Timing of Therapies and Sensitive Discussions With Patients

Breast cancer during pregnancy is relatively uncommon; however, it poses a significant clinical challenge to the patient and her multidisciplinary care team. To shed light on this difficult issue, The ASCO Post spoke with Carey K. Anders, MD, a medical oncologist and researcher at the University...

Breast Cancer

For Breast Cancer Specialist Ann H. Partridge, MD, MPH, Medicine Is a Family Tradition

Breast cancer specialist Ann H. Partridge, MD, MPH, was born in Manhasset, Long Island, and grew up several miles east in Muttontown, New York. Since tiny Muttontown didn’t have its own school system, Dr. Partridge went to high school in nearby Locust Valley, a town on Long Island’s North Shore,...

Breast Cancer

Expert Point of View: Nadia Harbeck, MD, PhD, and Sibylle Loibl, MD

NADIA HARBECK, MD, PhD, of the Breast Center at the University of Munich, Germany, said the findings of LORELEI are among a growing list of indications that “the future is bright for endocrine-based therapy.”  Although the results were hypothesis-generating and not yet practice-changing, she...

Breast Cancer

Selective PI3K Inhibitor Boosts Effect of Letrozole in Neoadjuvant Setting

FOR THE first time, an inhibitor of the phosphoinositide 3-kinase (PI3K) pathway (taselisib) used in combination with endocrine therapy in the neoadjuvant setting improved response rates over endocrine therapy alone—with good tolerability—in women with early breast cancer, according to the phase...

Breast Cancer

Expert Point of View: Nicholas Turner, MD

NICHOLAS TURNER, MD, of The Royal Marsden and the Institute of Cancer Research in the UK, called the findings of MONARCH 3 “practice-changing.” The cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have answered the need for agents that target the biology of estrogen receptor–positive breast cancer, ...

Breast Cancer

Abemaciclib Plus Endocrine Therapy Extends Progression-Free Survival in First-Line Therapy for Advanced Breast Cancer

THE VALUE OF cyclin-dependent kinase 4/6 (CDK4/6) inhibitors in advanced breast cancer became ever more certain with the announcement of interim data from MONARCH 3, which evaluated abemaciclib in combination with endocrine therapy as first-line therapy for hormone receptor–positive/HER2-negative...

breast cancer

Study Finds 'Standard Care' Treatments in Breast Cancer Clinical Trials Not Always Standard

Historically, randomized controlled trials have served as the state-of-the-art method for determining the efficacy and safety of new, innovative treatment regimens for patients with cancer and other diseases. It is imperative that such trials are carefully designed to ensure that they are...

breast cancer

FDA Grants Priority Review for Pertuzumab for Adjuvant Treatment of HER2-Positive Early Breast Cancer

On September 29, Roche announced the U.S. Food and Drug Administration (FDA) has accepted the company’s supplemental Biologics License Application and granted Priority Review for pertuzumab (Perjeta), in combination with trastuzumab (Herceptin) and chemotherapy, for adjuvant treatment of...

breast cancer

10-Year Survival With vs Without Axillary Dissection in Invasive Breast Cancer With Sentinel-Node Metastasis

As reported in JAMA by Giuliano et al, 10-year overall survival in the ACOSOG Z0011 (Alliance) trial with sentinel lymph node dissection (SLND) alone was noninferior to that with axillary lymph node dissection (ALND) in women with clinical T1 or T2 invasive breast cancer, no palpable axillary...

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