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breast cancer

AKT Inhibitor Ipatasertib in Metastatic Triple-Negative Breast Cancer

The randomized phase II LOTUS trial has shown improved progression-free survival with the addition of the AKT inhibitor ipatasertib to paclitaxel in the first-line treatment of metastatic triple-negative breast cancer. These results were reported by Kim et al in The Lancet Oncology. The PI3K/AKT...

breast cancer
issues in oncology

Comparison of Screening Recommendations for Mammography

When to initiate screening for breast cancer, how often to screen, and how long to screen are questions that continue to spark emotional debates. A new study compares the number of deaths that might be prevented as a result of three of the most widely discussed recommendations for screening...

Solid Tumors
Breast Cancer

A Personal Tribute to Angela H. Brodie, PhD, a Scientist Who Transformed Breast Cancer Treatment

Angela H. Brodie, PhD, a pioneer in breast cancer research, passed away on June 7, 2017, from complications of Parkinson’s disease and pancreatic cancer. An obituary for Dr. Brodie was published previously in the June 25, 2017, issue of The ASCO Post. Here, Dr. Balkees Abderrahman shares a...

Solid Tumors
Breast Cancer

Making Our Future Plans Happen Now

The following essay by Hope S. Rugo, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. I was in...

Breast Cancer

Triple-Negative Breast Cancer: Practical Approach, Promising Research

Triple-negative breast cancer has a reputation for being a particularly challenging malignancy, but breast cancer specialist Nancy Davidson, MD, Senior Vice President of the Clinical Research Division at the Fred Hutchinson Cancer Research Center, Seattle, put this in perspective in a recent...

breast cancer

Surveillance Mammography by Life Expectancy in Older Breast Cancer Survivors

In a study reported in the Journal of Clinical Oncology, Freedman et al found that many older breast cancer survivors with a limited life expectancy still undergo annual surveillance mammography despite the absence of known benefits. Study Details The study involved analysis of National Health...

breast cancer

Partial-Breast and Reduced-Dose Radiotherapy After Breast-Conserving Surgery

The UK IMPORT LOW phase III trial has shown noninferiority in local relapse for partial-breast and reduced-dose vs standard whole-breast radiotherapy after breast-conserving surgery in early breast cancer. These study results were reported by Coles et al in The Lancet. Study Details In the...

breast cancer

Genomic Characteristics and Immune Infiltration in Triple-Negative Breast Cancer

In a study reported in JAMA Oncology, Karn et al found that triple-negative breast cancers with high immune gene expression levels were characterized by lower clonal heterogeneity, reduced copy number alterations, and lower somatic mutation and neoantigen loads. Study Details In the study, DNA...

breast cancer

Effect of Radiotherapy After Breast-Conserving Surgery Among Breast Cancer Subtypes

In an analysis of the Swedish Breast Cancer Group 91 Radiotherapy trial reported in the Journal of Clinical Oncology, Sjöström et al found that adjuvant radiotherapy vs no radiotherapy had an increased benefit in triple-negative disease and little effect on HER2-positive disease in a...

breast cancer

Predisposition to Breast Cancer Due to Mutations Other Than BRCA1 and 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 study 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 van Hellemond et al, 12% of women with breast cancer who had chemotherapy-induced ovarian function failure experienced ovarian function recovery during 30 months of aromatase inhibitor therapy with anastrozole....

breast cancer
issues in oncology

Perioperative Anti-inflammatory, Antistress Drugs May Reduce Postsurgical Metastatic Disease Recurrence

Most cancer-related deaths are the result of postsurgical metastatic recurrence. A new Tel Aviv University (TAU) study published by Shaashua et al in Clinical Cancer Research found a specific drug regimen administered prior to and after surgery significantly reduces the risk of postsurgical cancer...

Breast Cancer

I Live My Life in 3- to 6-Month Increments

I first noticed a lump in my left breast in 2001 while taking a shower and shrugged it off. After all, men don’t get breast cancer. To assuage my wife’s concern that I at least have the lump examined, I consented to see our family physician, who agreed that men don’t get breast cancer because, he...

breast cancer

Trastuzumab-Based Regimens in Older Women With Early Breast Cancer

A comparative analysis of outcomes with two different trastuzumab (Herceptin)-based adjuvant regimens in older women with early HER2-positive breast cancer found little difference in safety and efficacy between treatments. The study was reported by Reeder-Hayes et al in the Journal of Clinical...

Breast Cancer

One Size May Not Fit All: Thoughts on the New Adjuvant Bisphosphonate Guideline for Early-Stage Breast Cancer

The oncology community has now conducted several prospectively designed, hypothesis-driven randomized clinical trials among women with breast cancer to address this question: Do adjuvant bisphosphonates decrease the risk of breast cancer bone metastases and other recurrence? A meta-analysis1 by...

Breast Cancer

Cancer Care Ontario and ASCO Clinical Practice Guideline: Use of Adjuvant Bisphosphonates and Other Bone-Modifying Agents in Breast Cancer

As reported in the Journal of Clinical Oncology by Sukhbinder Dhesy-Thind, MD, MSc, FRCPC, of Juravinski Cancer Centre, Hamilton Health Sciences, and colleagues, Cancer Care Ontario and ASCO have issued a clinical practice guideline on the use of adjuvant bisphosphonates and other bone-modifying...

Breast Cancer

Advances in the Treatment of Triple-Negative Breast Cancer

WITHIN THE SPECTRUM of breast cancer subtypes, triple-negative disease is “particularly troubling,” but better scientific understanding of this malignancy is leading to advances in its treatment, according to breast cancer expert Nancy Davidson, MD.  Triple-negative breast cancer does not express...

Breast Cancer
Leukemia
Supportive Care
Gastrointestinal Cancer

FDA Actions Yield Extended Approvals of Novel Agents, Advisory Committee Votes Favorably on Two Biosimilars and Pediatric Indication for CAR T-Cell Therapy

DURING JULY, the U.S. Food and Drug Administration (FDA) and its Oncologic Drugs Advisory Committee (ODAC) made a number of approvals and recommendations on a variety of oncology products.  Neratinib  ON JULY 1 7, the FDA approved neratinib (Nerlynx) for the extended adjuvant treatment of adult...

Breast Cancer

A New Triumvirate in Estrogen Receptor–Positive Metastatic Breast Cancer

THE BODY OF EVIDENCE supporting the use of cell-cycle inhibitors in combination with endocrine therapy for estrogen receptor–positive metastatic breast cancer now has another agent in the spotlight. The phase III MONARCH 2 trial—reported at the 2017 ASCO Annual Meeting and by Sledge et al in the...

Breast Cancer

MammaPrint Test Addressed in ASCO Breast Cancer Guideline Update

New recommendations on the use of the MammaPrint genomic test issued on July 10 will help guide decisions on adjuvant systemic therapy for women with early breast cancer. The recommendations update the ASCO 2016 clinical practice guideline on the use of biomarkers in these patients. The guideline ...

breast cancer

10-Year Follow-up on Adjuvant Tamoxifen and Exemestane 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...

breast cancer

Effect of BRCA1/2 Status on Response to Neoadjuvant Carboplatin 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

Fulvestrant Receives EC Approval as First-Line Therapy for Advanced Breast Cancer

On July 26, the European Commission (EC) approved fulvestrant (Falsodex) for the treatment of estrogen receptor–positive, locally advanced or metastatic breast cancer in postmenopausal women not previously treated with endocrine therapy. The EC approval is based on pivotal data from the...

breast cancer

Association of Bisphosphonate Use and Breast Cancer Risk in Postmenopausal Women

A study in postmenopausal women in the French E3N prospective cohort indicated bisphosphonate use was not associated with a reduced risk of breast cancer. These findings were reported by Fournier et al in the Journal of Clinical Oncology. Study Details The study included 64,438 postmenopausal...

breast cancer

Breast Cancer Survivor Preferences for Providers of Aspects of Primary Care After Cancer Treatment

In a study reported in the Journal of Clinical Oncology, Wallner et al found that minority women vs white women and women with a lower vs higher attained education level were more likely to prefer oncology-directed care vs primary care provider–directed care for aspects of care normally...

breast cancer

Genetic Study Identifies Susceptibility Loci Modifying Risk for Breast Cancer After Radiation Therapy for Childhood Cancer

As reported in the Journal of the National Cancer Institute, Morton et al have identified gene loci associated with radiation-related risk of breast cancer in survivors of childhood cancer. Study Details The study was a genome-wide association study of breast cancer in female survivors of...

breast cancer

Neoadjuvant Ado-trastuzumab Emtansine vs Trastuzumab in Early HER2-Positive, HR-Positive Breast Cancer

A West German Study Group phase II trial, reported by Harbeck et al in the Journal of Clinical Oncology, has shown a higher pathologic complete response rate with neoadjuvant ado-trastuzumab emtansine (formerly known as T-DM1; Kadcyla) with or without endocrine therapy vs trastuzumab (Herceptin)...

Breast Cancer

Digital Tomosynthesis vs Mammography in Unmasking Breast Cancer

DIGITAL TOMOSYNTHESIS is rapidly replacing full-field digital mammography, because “it allows a more efficient diagnostic workflow and leads to a more confident interpretation,” according to Elizabeth A. Morris, MD, FACR, Chief of the Breast Imaging Service, Memorial Sloan Kettering Cancer Center, ...

Breast Cancer
CNS Cancers

Breast Cancer and Brain Metastases: Whole-Brain Radiotherapy May Not Be the Answer

FOR PATIENTS WITH BREAST CANCER who have metastases to the central nervous system (CNS), clinicians should think twice before administering whole-brain radiotherapy, according to Kimberly Blackwell, MD, Professor of Medicine and Assistant Professor of Radiation Oncology at Duke University Medical...

breast cancer
solid tumors

CDK4/6 Inhibitors Have a Manageable Toxicity Profile, Are Generally Well Tolerated in Patients With Breast Cancer

A class of oral drugs for treating breast cancer known as cyclin-dependent kinase (CDK) 4/6 inhibitors are generally well-tolerated, with a manageable toxicity profile for most patients. This is the conclusion of a comprehensive review of toxicities and drug interactions related to this class of...

breast cancer

Neoadjuvant Radiation Reduces Risk of Secondary Tumors in Early-Stage Breast Cancer

Moffitt Cancer Center researchers conducted a first-of-its-kind study comparing the long-term benefits of radiation therapy in women with breast cancer in the neoadjuvant and adjuvant settings. Their study, published by Poleszczuk et al in Breast Cancer Research, found that patients who have...

breast cancer

MammaPrint Scoring and Indolent Node-Negative Breast Cancer

In an analysis reported in JAMA Oncology, Esserman et al found that an ultralow-risk designation using the 70-gene MammaPrint assay is capable of identifying patients with node-negative disease who have a very low long-term risk of death from breast cancer after surgery without systemic therapy....

breast cancer

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

Today, the U.S. Food and Drug Administration approved neratinib (Nerlynx) for the extended adjuvant treatment of adult patients with early-stage HER2-overexpressed/amplified breast cancer, to follow adjuvant trastuzumab (Herceptin)-based therapy. ExteNET Trial Approval was based on the ExteNET...

breast cancer

Anthracycline-Free Adjuvant Treatment in Early TOP2A-Normal Breast Cancer

The Danish phase III DBCG 07-READ trial has shown no difference in disease-free survival with adjuvant docetaxel/cyclophosphamide vs epirubicin, cyclophosphamide, and docetaxel in patients with early TOP2A-normal breast cancer. These trial results were reported in the Journal of Clinical Oncology...

breast cancer

Priority Review Granted for Abemaciclib in the Treatment of Advanced Breast Cancer

On July 10, the U.S. Food and Drug Administration (FDA) accepted a new drug application (NDA) for abemaciclib, a cyclin-dependent kinase (CDK) 4/6 inhibitor, and gave the NDA a Priority Review designation. The NDA includes Eli Lilly and Company’s submission of abemaciclib for two indications: ...

breast cancer

MammaPrint Test Addressed in ASCO Breast Cancer Guideline Update

New recommendations on the use of the MammaPrint genomic test issued on July 10 will help guide decisions on adjuvant systemic therapy for women with early breast cancer. The recommendations update the ASCO 2016 clinical practice guideline on the use of biomarkers in these patients. The...

breast cancer

Effect of Patient-Reported Symptoms on Adherence to Preventive Treatment for Breast Cancer

In an analysis of the UK cohort of the International Breast Cancer Intervention Study (IBIS-I) reported in the Journal of Clinical Oncology, Smith et al found similar effects of predefined symptoms on nonadherence in both tamoxifen and placebo recipients. IBIS-I randomized women at high risk of...

Breast Cancer

Neoadjuvant Studies of Endocrine Approaches in Breast Cancer Mandated Before Embarking on Large Adjuvant Studies

Largely based on studies demonstrating that letrozole can suppress plasma estradiol levels to a greater extent than anastrozole,1 the adjuvant activity of these endocrine agents were compared in 4,136 patients with node-positive breast cancer in the FACE trial. As reviewed in this issue of The ASCO ...

Breast Cancer

No Efficacy Difference Between Adjuvant Letrozole and Anastrozole in Postmenopausal Women With Early Breast Cancer

As reported in the Journal of Clinical Oncology by Ian E. Smith, MD, of The Royal Marsden Hospital and Institute of Cancer Research, and colleagues, final results of the phase III FACE trial showed no difference in disease-free or overall survival for adjuvant letrozole vs anastrozole in...

Breast Cancer

Expert Point of View: Leisha A. Emens, MD, PhD

STUDY DISCUSSANT Leisha A. Emens, MD, PhD, of Bloomberg~Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, Baltimore, entitled her remarks, “Target Practice in Triple-Negative Breast Cancer,” referring to the fact that there is currently no validated target in this aggressive...

Breast Cancer

Potent PARP Inhibitor Moves Ahead in BRCA-Mutated Breast Cancer

TALAZOPARIB, a novel inhibitor of poly (ADP-ribose) polymerase (PARP), showed encouraging efficacy in breast cancer patients with BRCA1/2 mutations in the phase II ABRAZO trial, presented at the 2017 ASCO Annual Meeting by Nicholas C. Turner, MD, of the Royal Marsden Hospital and The Institute of...

breast cancer

Fat Grafting and Patient-Reported Outcomes in Postmastectomy Breast Reconstruction

The use of fat grafting as a tool for breast reconstruction following a mastectomy may improve breast satisfaction, psychosocial well-being, and sexual well-being in patients, according to a study published by Bennett et al in JAMA Surgery. Fat grafting as an adjunct to breast reconstruction...

Breast Cancer

Expert Point of View: Leisha A. Emens, MD, PhD

Leisha A. Emens, MD, PhD, of the Bloomberg~Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, commented on the promise of anti–programmed cell death protein 1/programmed cell death ligand 1 (PD-1/PD-L1) agents in triple-negative breast cancer. She noted that “an emerging theme...

Breast Cancer

Pembrolizumab Moving Forward in Triple-Negative Breast Cancer

In the treatment of triple-negative breast cancer, checkpoint inhibition is making inroads in both early- and late-stage disease, and the line of treatment and expression of the programmed cell death ligand 1 (PD-L1) could be important in determining outcomes, according to studies reported at the...

Breast Cancer

Scalp Cooling to Prevent Chemotherapy-Induced Alopecia: Is It Now Ready for Prime Time?

In oncology, sometimes we forget about the small, everyday things that can significantly impact a patient’s life. When patients are explained the side effects of chemotherapy and chemotherapy-induced alopecia, most women will cry or become visibly upset. When a woman loses her hair, it represents...

Breast Cancer

Two Studies Show Scalp Cooling Reduces Hair Loss in Women Receiving Chemotherapy for Breast Cancer

An interim analysis of the SCALP trial, reported in JAMA by Julie Nangia, MD, of Baylor College of Medicine, and colleagues, showed that use of a scalp-cooling device significantly reduced hair loss in women receiving chemotherapy for stage I or II breast cancer compared with no scalp cooling.1 The ...

breast cancer

Interventionist-Guided Weight Loss Program for African American Breast Cancer Survivors

As reported by Stolley et al in the Journal of Clinical Oncology, a community-based interventionist-guided weight loss program for African American breast cancer survivors (Moving Forward) proved successful in achieving weight loss goals compared with a self-guided weight loss program. African...

breast cancer

Study Estimates Risks of Breast and Ovarian Cancers in BRCA1/2-Mutation Carriers

In a prospective cohort study reported in JAMA, Kuchenbaecker et al derived estimates of cumulative risks for breast, ovarian, and contralateral breast cancers among women carrying BRCA1 or BRCA2 mutations. Study Details The study involved data from 6,036 BRCA1 and 3,820 BRCA2 carriers recruited...

Breast Cancer

Expert Point of View: Harold Burstein, MD, Carey Anders, MD, and William Sikov, MD

Several breast cancer experts weighed in on the findings of the APHINITY trial. At an ASCO press briefing, Harold Burstein, MD, Associate Professor of Medicine at Harvard Medical School and breast cancer specialist at Dana-Farber Cancer Institute, Boston, pointed out that investigators estimated a ...

Breast Cancer

Positive Results for APHINITY, but Value of Benefit of Dual HER2 Blockade Questioned

The results of the long-awaited APHINITY trial are in, and although the phase III study met its primary endpoint, it failed to establish dual HER2 blockade as the optimal adjuvant treatment for early HER2-positive breast cancer. After 3 years of follow-up, the addition of pertuzumab (Perjeta) to...

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