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This is Part 3 of Novel Therapies for Advanced Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Aditya Bardia, Sara Tolaney, and Antonio C. Wolff discuss the treatment of relapsed/refractory triple-negative breast cancer. The patient is a 35-year-old female with metastatic PD-L1–positive triple negative breast cancer (HER2 IHC = 1+) who experiences disease progression on first-line therapy with carboplatin plus pembrolizumab. She has good performance status and is negative for germline BRCA mutations. The faculty discuss how best to choose between the antibody-drug conjugates sacituzumab govitecan and trastuzumab deruxtecan in the second-line setting and beyond, dose modifications to reduce toxicities and maintain quality of life, and the sequential use of antibody-drug conjugate after antibody-drug conjugate.
This is Part 2 of Novel Therapies for Advanced Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Aditya Bardia, Sara Tolaney, and Antonio C. Wolff discuss the role of HER2 expression in hormone receptor–positive metastatic breast cancer. The patient is a 55-year-old female with metastatic hormone receptor–positive metastatic breast cancer (HER2 IHC = 1). She has experienced disease progression various endocrine-based therapies, and recently capecitabine and paclitaxel. She has a good performance status, is negative for germline BRCA mutations, and is PIK3CA and ESR1 wild-type. The faculty review the shifting understanding of HER2 expression categories—particularly “HER2-low”—in breast cancer in the wake of the DESTINY-Breast04 study, best practices when it comes to distinguishing IHC 0 from IHC 1+, and current antibody-drug conjugates available and in the pipeline for metastatic breast cancer.
This is Part 1 of Novel Therapies for Advanced Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Aditya Bardia, Sara Tolaney, and Antonio C. Wolff discuss the treatment of hormone receptor–positive, HER2-negative metastatic breast cancer. The patient is a 65-year-old female who was diagnosed with localized hormone receptor–positive/HER2-negative breast cancer in 2010. After completion of adjuvant exemestane, she experiences disease recurrence in the bone 6 years later and starts treatment with letrozole plus a CDK4/6 inhibitor. Two years later, she experiences disease progression with continued bone involvement and new liver lesions. In the conversation that follows, the faculty discuss treatment options in the post–CDK4/6 inhibitor setting, the importance of genetic testing for actionable alterations, and novel therapies currently in development.
Researchers have found that about one-third of treatment recommendations from the artificial intelligence (AI) model ChatGPT 3.5 were nonconcordant with the NCCN Clinical Practice Guidelines in Oncology® (NCCN Guidelines®), according to a recent study published by Chen et al in JAMA Oncology. The...
In a single-center retrospective study reported in the Journal of Clinical Oncology, Eskreis-Winkler et al found that contrast-enhanced magnetic resonance imaging (MRI) using a high-temporal/high-spatial resolution (HTHS) protocol improved breast cancer detection and reduced unnecessary biopsies vs ...
The antibody-drug conjugate sacituzumab govitecan-hziy continued to demonstrate superior benefit for patients with hormone receptor–positive, HER2-negative metastatic breast cancer when compared with standard chemotherapy, according to the final analysis of the phase III TROPiCS-02 study published...
In an analysis from a phase II European trial reported in JAMA Oncology, Jens Huober, MD, and colleagues found no difference in overall survival with pertuzumab/trastuzumab, with or without chemotherapy, followed by second-line ado-trastuzumab emtansine (T-DM1) in patients with HER2-positive...
In a German prospective registry study (SenTa) reported in JAMA Surgery, Kuemmel et al found that targeted axillary dissection alone after neoadjuvant systemic therapy was associated with outcomes similar to those obtained with targeted axillary dissection plus axillary lymph node dissection in...
In a Canadian study reported in the Journal of Clinical Oncology, Wilkinson et al found that breast cancer screening was associated with greater 10-year breast cancer net survival among women aged 40 to 49 living in jurisdictions including mammography screening programs for this age group, compared ...
Researchers have identified genes that may be associated with breast cancer and could eventually be included in tests to identify high-risk patients, according to a recent study published by Wilcox et al in Nature Genetics. Background Currently, genetic tests for breast cancer consider a few genes...
New approaches are offering hope for better outcomes in metastatic triple-negative breast cancer, according to Suchita Pakkala, MD, of Emory University’s Winship Cancer Institute, Atlanta. She shared her thoughts on using PARP inhibitors and antibody-drug conjugates at the 2023 Debates and...
Long-molecule scars may help identify patients with BRCA1- and BRCA2-deficient cancer types, according to a recent study published by Setton et al in Nature. Background Once DNA is damaged by toxins, radiation, or normal cell division, human cells must continually fix DNA breaks to survive. When...
In a South Korean single-center retrospective cohort study reported in JAMA Surgery, Cheun et al identified locoregional recurrence patterns according to molecular subtypes of breast cancer among women undergoing surgery for the disease. The study involved data from 16,462 women who underwent...
Continued breast cancer screening after age 70 may be associated with a greater incidence of asymptomatic cancer, according to a recent study published by Richman et al in the Annals of Internal Medicine. These new findings suggested that overdiagnosis may be prevalent among older female patients....
In a preplanned analysis of the phase III PALLAS trial reported in the Journal of Clinical Oncology, Pfeiler et al found that higher body mass index (BMI) reduced the risk of neutropenia and treatment discontinuation in patients with early hormone receptor–positive breast cancer receiving adjuvant...
In a Swedish study (Mammography Screening with Artificial Intelligence [MASAI]) reported in The Lancet Oncology, Lång et al found that artificial intelligence (AI)-supported screen reading was associated with a similar cancer detection rate and a lower screen-reading workload vs standard double...
In a systematic review and meta-analysis reported in the Journal of Clinical Oncology, Bright et al found that interventions to promote adjuvant endocrine therapy adherence in breast cancer survivors were successful overall compared with control conditions, although some interventions appeared to...
Susan M. Love, MD, MBA, a renowned surgeon, author, researcher, and patient advocate who dedicated her life’s work to breast cancer care, died on July 2, 2023, at her home in Los Angeles. The cause of death was recurrent leukemia. She was 75. Born in Long Branch, New Jersey, on February 9, 1948,...
A report published by Kwan et al in the journal Cancer provides new information that may help oncologists answer one of the most common questions they hear from breast cancer survivors: Is it safe to drink alcohol? The findings suggest drinking alcohol is not associated with an increased risk of...
A machine-learning model found that background parenchymal enhancement (BPE) on breast magnetic resonance imaging (MRI) may be an indicator of breast cancer risk in patients with extremely dense breasts, according to a study published by Wang et al in Radiology. Patients with extremely dense...
ASCO has been awarded $11 million in research funding by the Patient-Centered Outcomes Research Institute (PCORI) to study dosing strategies of oral CDK4/6 inhibitors in older adults living with metastatic breast cancer. The study aims to address a critical evidence gap in the treatment of this...
Two studies presented at the 2023 ASCO Annual Meeting challenge the use of CDK4/6 inhibitors as part of upfront treatment of advanced hormone receptor–positive, HER2-negative breast cancer. The first, the SONIA trial, found that first-line treatment with CDK4/6 inhibitors led to greater toxicity...
The probability of obtaining a HER2-low test result increases with the number of biopsies performed, according to a study of more than 500 biopsy samples in patients with triple-negative breast cancer. For patients originally labeled as having no HER2 expression (HER2 0), each successive biopsy...
A study covering the northeast region of Colombia found nearly 12% of patients with a high body mass index (BMI) being treated for breast cancer at a regional center experienced cardiotoxicity during chemotherapy. The study will be presented at the upcoming American College of Cardiology Latin...
In a study reported in JAMA Network Open, KC et al identified factors involved with primary cancer mortality vs noncancer mortality among long-term survivors of breast, prostate, and colorectal cancers. Study Details The study included data on 627,702 patients in the Surveillance, Epidemiology,...
Syrian migrants, including refugees, may be more likely to be diagnosed with a more advanced stage of breast cancer at a younger age when compared with individuals from Jordan, according to a recent study published by Hazra et al in JAMA Network Open. The new findings suggest the trauma associated...
In partnership with the College of American Pathologists (CAP), ASCO has affirmed findings from its 2018 practice guideline on the use of HER2 testing in breast cancer. Notably, the ASCO/CAP expert panel found there is currently no justification for a new designation of HER2 test results for...
Barbara Pistilli, MD, Head of the Breast Cancer Unit in the Medical Oncology Department of Gustave Roussy Cancer Center, Villejuif, France, was invited to discuss the TROPiCS-02 updated analysis. She began by pointing out that the target landscape of antibody-drug conjugates is “expanding...
Additional follow-up of the phase III TROPiCS-02 trial has upheld the progression-free and overall survival benefit seen with sacituzumab govitecan-hziy compared with physician’s choice of treatment in patients with endocrine-resistant, hormone receptor–positive, HER2-negative metastatic breast...
The invited discussant of the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) meta-analysis, Ines Vaz-Luis, MD, PhD, of the Breast Cancer Survivorship Group, Gustave Roussy, Villejuif, France, pointed out that the benefit of ovarian suppression or ablation in reducing breast cancer...
A meta-analysis of randomized trials has revealed a benefit to ovarian ablation or suppression in preventing breast cancer recurrence in premenopausal women with estrogen receptor–positive tumors.1 The findings, based on almost 15,000 women in studies spanning several decades, were presented at the ...
Some patients who have received treatment for breast cancer may experience increased biological aging compared with those who have never been diagnosed with breast cancer, according to a new study published by Kresovich et al in the Journal of the National Cancer Institute. The findings showed that ...
“Triple-negative breast cancer remains the most challenging subtype to treat because of its aggressive phenotype and limited treatment options,” stated Erica Michelle Stringer-Reasor, MD, who spoke at an education session on current approaches to treatment and future directions during the 2023 ASCO ...
Recent improvements in overall and progression-free survival for patients with HER2-positive and estrogen receptor–positive breast cancers have not come at the expense of quality of life or symptom management, according to a pair of studies presented at the European Society for Medical Oncology...
In a secondary analysis from the SWOG S1007 trial reported in JAMA Oncology, Reshma Jagsi, MD, DPhil, and colleagues found low rates of locoregional recurrence irrespective of the use of regional nodal irradiation in patients with favorable-risk, node-positive breast cancer receiving radiation...
Researchers have uncovered a potential link between chemotherapy-induced changes to gut bacteria and weight gain seen in patients with breast cancer, according to a recent study published by Walker et al in BMC Medicine. The findings may help to identify approaches to avoid obesity-related diseases ...
Session co-moderator Kevin Kalinsky, MD, MS, the Louisa and Rand Glenn Family Chair in Breast Cancer Research, Director of the Glenn Family Breast Center, and Director of Breast Medical Oncology at the Winship Cancer Institute of Emory University, Atlanta, offered his thoughts on PHERGain to The...
The phase II PHERGain trial, which employed a response-adapted strategy in the treatment of early-stage, HER2-positive breast cancer, has shown promising results for the selective use of HER2 blockade and de-escalation of chemotherapy.1 Nearly all patients assigned to skip chemotherapy prior to...
When I felt a large mass in my left breast as I was drying off from a shower on Thanksgiving Day, in 2007, I instinctively knew it was cancer. My mother had been diagnosed with breast cancer when she was 38, just 7 years older than I was at the time, and died 4 years later. I was 6 when she was...
Guest Editor’s Note: Psychological distress is highly prevalent in women diagnosed with premenopausal breast cancer and has a significant negative impact on their quality of life. Thus, effective strategies are urgently needed to reduce the symptom burden. In this installment of The ASCO Post’s...
As a relatively rare subtype, lobular breast cancer is not well understood by many oncologists. At the 2023 Miami Breast Cancer Conference, Tari A. King, MD, FASCO, described how it differs from its more common counterpart, ductal breast cancer, in terms of characteristics, prognosis, and optimal...
Axillary management decisions made during surgery may be associated with aggressive treatment of limited nodal disease, according to data presented at a press briefing at the 2023 American Society of Breast Surgeons Annual Meeting.1 Results of a large National Cancer Database study revealed that...
Researchers have created the world’s largest and most comprehensive atlas of normal breast tissue—the Human Breast Cell Atlas—which may provide an unprecedented understanding of mammary biology and help identify therapeutic targets for diseases such as breast cancer, according to a recent study...
In the phase II AMEERA-3 trial reported in the Journal of Clinical Oncology, Sara M. Tolaney, MD, MPH, and colleagues found that the selective estrogen receptor degrader amcenestrant did not improve progression-free survival vs physician’s choice of endocrine therapy in patients with estrogen...
Iopromide-300 and -370 (Ultravist), an iodine-based contrast agent, has been approved by the U.S. Food and Drug Administration (FDA) for contrast-enhanced mammography—making it the only contrast agent approved for this indication. The product can be used to visualize known or suspected lesions of...
Investigators have found that artificial intelligence (AI) language models like OpenAI’s ChatGPT may accurately identify appropriate imaging tests for breast cancer screenings and breast pain, according to a recent study published by Rao et al in the Journal of the American College of Radiology....
Testing for the emergence of ESR1 mutations should be routine at disease recurrence or progression for patients with estrogen receptor (ER)-positive, HER2-negative metastatic breast cancer whose disease is being managed with endocrine therapy, according to an ASCO guideline rapid recommendation...
In the phase III IMPORT HIGH trial reported in The Lancet, Charlotte E. Coles, FRCR, and colleagues found little difference in ipsilateral breast tumor relapse rates with adjuvant dose-escalated simultaneous integrated boost radiotherapy vs lower-dose sequential boost radiotherapy in patients with...
The addition of the CDK4/6 inhibitor ribociclib to endocrine therapy significantly improved invasive disease–free survival in women with hormone receptor–positive, HER2-negative, early-stage breast cancer. These results of the phase III NATALEE trial were reported by lead author Dennis J. Slamon,...
In a Canadian study reported in the Journal of Clinical Oncology, Dayes et al found that positron-emission tomography/computed tomography–fluorodeoxyglucose (PET/CT-FDG) improved the detection of distant metastasis vs conventional staging in patients with locally advanced breast cancer. It also...