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Breast Cancer

International Trials Present New Findings in Treatment of Breast Cancer

The European Society for Medical Oncology (ESMO) 2018 Congress featured an assortment of study findings, many with far-reaching clinical implications for the treatment of patients with various cancers. Many of these trials were covered in-depth in recent issues of The ASCO Post. Here, we present...

Breast Cancer
Supportive Care

Has Scalp Cooling Reached the Level of Standard of Care?

Does evidence of the effectiveness and safety of scalp cooling to reduce hair loss among women being treated for breast cancer mean that scalp cooling is a new standard of care? “I would suggest that it is,” stated Mikel Ross, MSN, RN, AGNP-BC, of the Breast Medicine Service, Memorial Sloan...

breast cancer

Adjuvant Trastuzumab Emtansine vs Trastuzumab in Patients With HER2-Positive Breast Cancer With Residual Disease After Neoadjuvant Therapy

As reported at the recent San Antonio Breast Cancer Symposium and in The New England Journal of Medicine by von Minckwitz et al, an interim analysis of the phase III KATHERINE trial has shown that adjuvant trastuzumab emtansine (T-DM1; Kadcyla) improved invasive disease–free survival vs...

Breast Cancer

AI Technology for Digital Breast Tomosynthesis Receives FDA Clearance for Clinical Use

A deep-learning, cancer detection software built on artificial intelligence (AI) called ProFound AI received clearance by the U.S. Food and Drug Administration (FDA) for commercial sales and clinical use in the United States. The announcement was made in a news release from iCAD, Inc., a global...

breast cancer

Disease-Free Survival With Letrozole vs Placebo After Aromatase Inhibitor–Based Therapy in Postmenopausal Breast Cancer

As reported by Mamounas et al in The Lancet Oncology, the phase III NRG Oncology/NSABP B-42 trial has shown no disease-free survival benefit with 5 years of letrozole (Femara) vs placebo after 5 years of aromatase inhibitor–based therapy in women with hormone receptor–positive...

breast cancer
issues in oncology

Increased Risk for Breast Cancer After Childbirth May Last More Than 2 Decades

Although parity—time since most recent birth— is recognized as a protective factor against breast cancer, an analysis of data from 15 prospective cohort studies to assess breast cancer risk in relation to recent childbirth has found that compared to women of the same age who had never...

Breast Cancer

Association Between Pathologic Complete Response After Neoadjuvant Chemotherapy and Breast Cancer Outcomes

A large comprehensive patient-level meta-analysis showed that achieving pathologic complete response after neoadjuvant chemotherapy correlates with significantly improved event-free survival and overall survival in patients with localized breast cancer. These findings were particularly robust in...

Breast Cancer

KATHERINE Trial: Adjuvant T-DM1 Reduces Invasive Disease Risk by 50% vs Trastuzumab in HER2-Positive Early Breast Cancer

In patients with HER2-positive early breast cancer and residual disease after neoadjuvant chemotherapy, adjuvant treatment with trastuzumab emtansine (T-DM1; Kadcyla) reduced the risk of invasive disease by 50% over trastuzumab (Herceptin).1 The phase III KATHERINE study was presented at the 2018...

breast cancer

Addition of Neoadjuvant Palbociclib to Letrozole in Estrogen Receptor–Positive Early Breast Cancer

In the phase II PALLET trial reported in the Journal of Clinical Oncology, Johnston et al found that the addition of neoadjuvant palbociclib (Ibrance) to letrozole increased rates of complete cell-cycle arrest, reduced apoptosis, and did not significantly improve clinical response rate in patients...

breast cancer

FDA Approves Trastuzumab-pkrb for HER2-Overexpressing Breast Cancer

On December 14, the U.S. Food and Drug Administration (FDA) approved trastuzumab-pkrb (Herzuma), a HER2/neu receptor antagonist biosimilar to trastuzumab (Herceptin), for the following indications: Adjuvant breast cancer of HER2 overexpressing node-positive or node-negative (estrogen...

breast cancer

Palbociclib Plus Fulvestrant in Advanced Breast Cancer: Overall Survival Analysis of PALOMA-3

An overall survival analysis of the PALOMA-3 trial reported by Turner et al in The New England Journal of Medicine found that the addition of the cyclin-dependent kinase 4/6 (CDK4/6) inhibitor palbociclib (Ibrance) to fulvestrant (Faslodex) improved survival among patients with hormone...

breast cancer

RSNA 2018: Mammography Screening Beyond Age 75

Women aged 75 years and older may benefit from continued screening mammograms because of the comparatively high incidence of breast cancer found in this age group, according to a study presented at the Annual Meeting of the Radiological Society of North America (RSNA) (Abstract SSA01-04)....

breast cancer

RSNA 2018: Breast Cancer Risk-Based Mammography Screening in Younger Women

A new, large-scale study of more than 5 million mammograms found that annual mammography screening beginning at age 30 may benefit women with at least 1 of 3 specific risk factors: dense breasts, a personal history of breast cancer, or a family history of breast cancer. The study was presented at...

breast cancer

RSNA 2018: Preliminary Results of Primary Cryoablation in Treating Low-Risk Breast Cancers

Cryoablation has shown early indications of effectiveness in treating women with low-risk breast cancers, according to research presented at the Annual Meeting of the Radiological Society of North America (RSNA) (Abstract SSM01-01). “If the positive preliminary findings are maintained as the ...

breast cancer

Hope S. Rugo, MD, on Metastatic Breast Cancer: Treatment for Pretreated Hormone Receptor–Positive Disease

Hope S. Rugo, MD, of the University of California, San Francisco, discusses how treatment with a lower dose of palbociclib (100 mg vs 125 mg) in combination with fulvestrant or tamoxifen is associated with a lower rate of high-grade neutropenia (Abstract PD2-12).

breast cancer
survivorship

POEMS/SWOG Intergroup S0230 Study on Preventing Early Menopause

In the long-term follow-up of the Prevention of Early Menopause Study (POEMS)/SWOG Intergroup S0230 trial reported in the Journal of the National Cancer Institute, Moore et al found that the addition of goserelin (Zoladex) to cyclophosphamide-containing chemotherapy was associated with a higher...

breast cancer
solid tumors
leukemia
lung cancer
lymphoma
multiple myeloma
issues in oncology
immunotherapy

FDA Pipeline: New Priority Reviews, Designations, and Clearances, Plus Statements on Genetic Testing and Class Labeling

The U.S. Food and Drug Administration (FDA) recently issued the following new approvals and designations: Priority Review for Atezolizumab in Combination With Chemotherapy for the Initial Treatment of Extensive-Stage SCLC The FDA accepted a supplemental biologics license application...

Breast Cancer

Management of HER2-Positive Breast Cancer: Business as Usual?

MANAGEMENT OF HER2-positive breast cancer changed after the introduction of trastuzumab (Herceptin), the first anti-HER2 therapy to be approved by the U.S. Food and Drug Administration (FDA) for this type of cancer. Recent studies have more clearly defined the role of pertuzumab (Perjeta) and...

Breast Cancer

Expert Point of View: Rebecca Dent, MD, and Suzette Delaloge, MD, MSc

FORMAL DISCUSSANT of the ACE trial, Rebecca Dent, MD, of the National Cancer Center in Singapore, commented that the phase II ENCORE 301 study provided proof of concept that a histone deacetylase (HDAC) inhibitor can reprogram epigenetic changes.1 In that randomized, double-blind,...

Breast Cancer

HDAC Inhibitor May Overcome Endocrine Resistance in Advanced Breast Cancer

EPIGENETIC CHANGES are associated with the development of cancer, and epigenetic therapy is an attractive strategy for targeting the tumor microenvironment. One approach targeted to epigenetic changes is using histone deacetylase (HDAC) inhibition, which has antitumorigenic effects including growth ...

breast cancer

Shanu Modi, MD, on Low HER2-Expressing Breast Cancer: Updated Trial Findings

Shanu Modi, MD, of Memorial Sloan Kettering Cancer Center, discusses study findings from a large phase I study on trastuzumab deruxtecan in patients with low HER2-expressing breast cancer (Abstract P6-17-02).

breast cancer
immunotherapy

Hope S. Rugo, MD, on Immunotherapy for Breast Cancer: Expert Perspective

Hope S. Rugo, MD, of the University of California, San Francisco, summarizes a spotlight session she chaired, which included discussion of new immunotherapy drug combinations, predictive factors, and the immune microenvironment.

breast cancer

Monica Morrow, MD, on View From the Trenches: What Will You do on Monday Morning?

Monica Morrow, MD, of Memorial Sloan Kettering Cancer Center reviews lessons learned from top abstracts, including how to tailor the extent of local therapy to minimize morbidity, the diminishing role of axillary lymph node dissection, long-term sequelae of breast surgical procedures, and the need to discuss outcomes with patients.

breast cancer

Shom Goel, MD, PhD, on Breast Cancer: Impact of CDK4/6 Inhibitors on Immunity

Shom Goel, MD, PhD, of the Dana-Farber Cancer Institute, discusses preclinical data that suggest CDK4/6 inhibitors not only stop the growth of breast cancer cells, but also enhance antitumor immunity, a phenomenon that might help improve outcomes for people with advanced disease.

breast cancer
immunotherapy

Roisin M. Connolly, MD, on Breast Cancer Treatment Advances in 2018: Expert Perspective

Roisin M. Connolly, MD, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, discusses clinical trials during the past year on studies on CDK and PI3K inhibitors in estrogen receptor–positive breast cancer and immune checkpoint agents in triple-negative breast cancer.

issues in oncology
breast cancer

Reshma Jagsi, MD, DPhil, and Rachel A. Freedman, MD, MPH, on Over- and Undertreatment: Getting It Right

Reshma Jagsi, MD, DPhil, of the University of Michigan, and Rachel A. Freedman, MD, MPH, of Dana-Farber Cancer Institute, discuss the twin challenges of overtreating people with cancer and the missed opportunities and dangers of undertreatment.

breast cancer
issues in oncology

Kathy S. Albain, MD, on Breast Cancer, Ethnicity, and Clinical Outcomes: Results From the TAILORx Trial

Kathy S. Albain, MD, of Loyola University Stritch School of Medicine, discusses study findings on race, ethnicity, and patient outcomes in hormone receptor–positive, HER2-negative, node-negative breast cancer (Abstract GS4-07).

breast cancer
geriatric oncology

Allison Magnuson, DO, on Older Patients With Breast Cancer: A New Tool to Help Guide Treatment Decisions

Allison Magnuson, DO, of the University of Rochester Strong Memorial Hospital, discusses the development of a chemotherapy toxicity risk score that is associated with dose reduction as well as reduced respiratory distress and fewer hospitalizations (Abstract GS6-04).

breast cancer
issues in oncology

Roberto A. Leon-Ferre, MD, on Decreasing Hot Flashes: Results From an ACCRU Trial

Roberto A. Leon-Ferre, MD, of the Mayo Clinic, discusses study findings on the effectiveness of oxybutynin in decreasing the frequency and severity of hot flashes (Abstract GS6-01).

breast cancer
genomics/genetics

Dejan Juric, MD, on Advanced Breast Cancer: Results From the SOLAR-1 Trial

Dejan Juric, MD, of Massachusetts General Hospital, discusses phase III study findings on liquid biopsy–based assessment of PIK3CA mutational status and the combination of the selective PI3K-alpha inhibitor alpelisib plus fulvestrant in the treatment of advanced breast cancer (Abstract GS3-08).

breast cancer
issues in oncology

Laura S. Dominici, MD, on Young Women With Breast Cancer: Local Therapy and Quality of Life

Laura S. Dominici, MD, of the Dana-Farber Cancer Institute, discusses the lower quality-of-life scores seen after unilateral or bilateral mastectomy compared with breast-conserving surgery in women younger than age 40 who are treated for breast cancer (Abstract GS6-05).

breast cancer
genomics/genetics

Judy E. Garber, MD, on Cancer Genetics: Updates for Breast Cancer Care

Judy E. Garber, MD, of the Dana-Farber Cancer Institute, summarizes a special session she moderated, which included discussion of polygenic risk scores, genetic testing in diverse populations, and what to do when presented with moderate-penetrance mutations.

breast cancer
issues in oncology

Shoshana M. Rosenberg, ScD, on Quality of Life and the Impact of Breast Cancer Surgery

Shoshana M. Rosenberg, ScD, of Dana-Farber Cancer Institute, discusses her study findings on the lower quality of life associated with mastectomy, and the need for intervention and timely referrals to supportive resources, especially for underserved populations (Abstract GS6-04).

breast cancer

Harold J. Burstein, MD, PhD, and Daniel F. Hayes, MD, on Breast Cancer With Positive Lymph Nodes: Treatment Controversy

Harold J. Burstein, MD, PhD, of the Dana-Farber Cancer Institute, and Daniel F. Hayes, MD, of the University of Michigan Rogel Cancer Center debate whether all women with breast cancer and positive lymph nodes should receive chemotherapy.

breast cancer
survivorship
symptom management

SABCS 2018: Oxybutynin for the Management of Hot Flashes in Women Unable to Receive Hormone Replacement Treatment

Treatment with oxybutynin helped reduce the frequency and intensity of hot flashes for women who could not take hormone replacement therapy, including breast cancer survivors, according to the results of a trial presented at the 2018 San Antonio Breast Cancer Symposium by Leon-Ferre et al (Abstract ...

breast cancer

SABCS 2018: SOLAR-1: Liquid Biopsies in Predicting Benefit of Alpelisib in PIK3CA-Mutant Breast Cancer

Liquid biopsy–based assessment of PIK3CA mutational status served as a better indicator of progression-free survival compared with analysis of tissue biopsy in patients with breast cancer enrolled in the phase III SOLAR-1 clinical trial, according to data presented by Juric et al at the 2018...

breast cancer

SABCS 2018: TAILORx Results Show Association Between Clinical Outcomes in Breast Cancer and Race

An analysis of the association between clinical outcomes and race in participants enrolled in the TAILORx trial found that even with equivalent treatments among women with hormone receptor–positive, HER2-negative breast cancer, black women had worse clinical outcomes than white women, despite ...

breast cancer
issues in oncology

SABCS 2018: Surgical Choice May Impact Long-Term Quality of Life in Young Adults With Breast Cancer

A study by Dominici et al investigated the long-term quality of life outcomes in young breast cancer survivors across three surgical strategies: breast-conserving surgery, unilateral mastectomy, and bilateral mastectomy. The researchers found that patients who underwent mastectomy had lower breast...

breast cancer

François-Clément Bidard, MD, PhD, on Metastatic Breast Cancer: Using Circulating Tumor Cells to Direct Treatment

François-Clément Bidard, MD, PhD, of the Institut Curie and the University of Versailles, discusses phase III study findings on the clinical utility of circulating tumor cell count as a tool to choose between first-line hormone therapy and chemotherapy for estrogen receptor–positive, HER2-negative metastatic breast cancer (Abstract GS3-07).

breast cancer

Andrew D. Seidman, MD, and Richard G. Gray, MA, MSc, on Long-Term Aromatase Inhibitor Therapy

Andrew D. Seidman, MD, of Memorial Sloan Kettering Cancer Center, and Richard G. Gray, MA, MSc, of the University of Oxford, discuss a meta-analysis of individual patient data from 12 randomized trials including 24,912 women on the effects—in terms of recurrence and cause-specific mortality—of prolonging adjuvant aromatase inhibitor therapy beyond 5 years (Abstract GS3-03).

breast cancer

Andrew D. Seidman, MD, and Miguel Martín, MD, PhD, on Triple-Negative Breast Cancer: Results From the CIBOMA/GEICAM Trial

Andrew D. Seidman, MD, of Memorial Sloan Kettering Cancer Center, and Miguel Martín, MD, PhD, of the Instituto de Investigacion Sanitaria Gregorio Marañón, discuss phase III study findings on adjuvant capecitabine after standard chemotherapy for people with early triple-negative breast cancer (Abstract GS2-04).

breast cancer

Andrew D. Seidman, MD, and Charles E. Geyer, MD, on HER2-Positive Breast Cancer: Results From the KATHERINE Trial

Andrew D. Seidman, MD, of Memorial Sloan Kettering Cancer Center, and Charles E. Geyer, MD, of Virginia Commonwealth University, discuss phase III study findings on ado-trastuzumab emtansine vs trastuzumab as adjuvant therapy in patients with early HER2-positive breast cancer with residual invasive disease after neoadjuvant chemotherapy and HER2-targeted treatment (Abstract GS1-10).

breast cancer

Eva M. Ciruelos, MD, PhD, on HER2-Positive Breast Cancer: Results From the PATRICIA Trial

Eva M. Ciruelos, MD, PhD, of the University Hospital 12 de Octubre and the SOLTI Group, discusses study findings on palbociclib and trastuzumab in postmenopausal patients with HER2-positive metastatic breast cancer (Abstract PD3-03).

breast cancer

Zaida Morante, MD, on Triple-Negative Breast Cancer: Delaying Adjuvant Chemotherapy

Zaida Morante, MD, of the Instituto Nacional de Enfermedades Neoplasicas, discusses retrospective study findings showing the importance of starting adjuvant chemotherapy for people with triple-negative breast cancer within 30 days of surgery (Abstract GS2-05).

breast cancer

Shoichiro Ohtani, MD, PhD, on Extending Adjuvant Aromatase Inhibitor Therapy: Phase III Trial Results

Shoichiro Ohtani, MD, PhD, of Hiroshima City Hiroshima Citizens Hospital, discusses study findings on extending anastrozole to 10 years, which led to higher rates of disease-free survival and distant disease–free survival (Abstract GS3-04).

breast cancer

Kathryn J. Ruddy, MD, MPH, on Breast Cancer and Quality of Life: Expert Perspective

Kathryn J. Ruddy, MD, MPH, of the Mayo Clinic, summarizes a special spotlight session that included discussion of interventions to improve quality of life and the importance of lifestyle in the prevention of cancer and cancer recurrence.

breast cancer

Xavier Pivot, MD, PhD, on Early Breast Cancer: Results From the PHARE Trial

Xavier Pivot, MD, PhD, of the Paul Strauss Cancer Center, discusses final study findings comparing 6 and 12 months of trastuzumab in adjuvant early breast cancer (Abstract GS2-07).

breast cancer

Sara A. Hurvitz, MD, on HER2-Positive Breast Cancer: Novel Treatments and Markers

Sara A. Hurvitz, MD, of the University of California, Los Angeles, discusses the natural history and novel combinations for HER2-positive disease as well as predictive and prognostic markers for this type of breast cancer.

Breast Cancer
Solid Tumors
Lung Cancer

A Diagnosis of Li-Fraumeni Syndrome Has Focused My Life Direction

Despite the fact that I had to have open heart surgery at age 7 to fix a congenital heart defect and then more surgery, chemotherapy, and radiation therapy to treat a diagnosis of rhabdomyosarcoma a year later, I never felt like I was a sick kid. Children don’t have the existential worries about...

breast cancer

SABCS 2018: Whole-Breast Irradiation vs Accelerated Partial-Breast Irradiation for Preventing Ipsilateral Breast Tumor Recurrence

Data from the NSABP B-39/RTOG 0413 trial indicated that ipsilateral breast tumor recurrence (IBTR) rates 10 years after treatment could not reject the hypothesis that accelerated partial-breast irradiation (PBI) after lumpectomy was inferior to whole-breast irradiation (WBI), according to a...

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