Study Identifies Factors Impacting Adherence to Oral Medications for Metastatic Breast Cancer
A recent study published by Conley et al in Breast Cancer Research and Treatment aimed to evaluate factors that influence the ability of people with metastatic breast cancer to adhere to their prescribed regimen of oral anticancer medication.1 Researchers found that multiple factors affected...
MRI and Mammography Breast Cancer Screening Strategies for Women With ATM, CHEK2, and PALB2 Pathogenic Variants
In an analysis reported in JAMA Oncology, Lowry et al found that a strategy of annual magnetic resonance imaging (MRI) screening starting at age 30 to 35 years—followed by annual MRI and mammography at age 40—could reduce the risk of breast cancer mortality by more than 50% in women with ATM,...
Prediction Model for BRCA Mutation–Carrying Status in Asian Patients With Breast Cancer
In an Asian study reported in the Journal of Clinical Oncology, Ang et al developed a model for predicting carrier status of pathogenic variants in BRCA1 or BRCA2 among Asian women with breast cancer. As stated by the investigators, “With the development of poly (ADP-ribose) polymerase inhibitors...
Racial Disparities in Outcomes for Patients With Early HR-Positive Breast Cancer After Adjustment for Insurance Status and Neighborhood Deprivation Index
In a post hoc analysis published in JAMA Oncology from the TAILORx trial of adjuvant therapy in early hormone receptor (HR)-positive, HER2-negative, axillary node–negative breast cancer, Sadigh et al found that Black women had a poorer relapse-free interval and overall survival vs White women. This ...
PADA-1 Trial: With Early Identification of ESR1 Mutation, Switch to Fulvestrant in Metastatic Breast Cancer
Switching from an aromatase inhibitor to fulvestrant upon early identification of the ESR1 mutation in plasma—before disease progression—doubled progression-free survival in the phase III PADA-1 trial, presented at the 2021 San Antonio Breast Cancer Symposium.1 “PADA-1 is the first trial to...
EMERALD Trial: Oral Selective Estrogen Receptor Degrader as Second- or Third-Line Therapy for Advanced Breast Cancer
Use of the first investigational oral selective estrogen receptor degrader (SERD) elacestrant significantly reduced the risk of death or disease progression and lengthened progression-free survival compared with standard-of-care endocrine therapy with fulvestrant or an aromatase inhibitor in...
Metformin Added to Standard Adjuvant Chemotherapy Fails to Improve Outcomes in Early Breast Cancer
The addition of metformin, a drug commonly used to treat type 2 diabetes, to standard adjuvant treatment failed to improve invasive disease–free survival or overall survival for hormone receptor–positive or –negative breast cancer, according to the results of a large landmark trial led by the...
Final Analysis of PALLAS Trial: No Benefit of Adjuvant Palbociclib Plus Endocrine Therapy in Early Breast Cancer
The final protocol-defined analysis of the phase III PALLAS trial confirmed the negative results of the second interim analysis, showing no benefit of palbociclib plus endocrine therapy in the adjuvant breast cancer setting. Michael Gnant, MD, of the Medical University of Vienna, reported these...
MONALEESA Analyses Show Widespread Benefit for Ribociclib in Hormone Receptor–Positive, HER2-Negative Breast Cancer
Further analyses of the MONALEESA metastatic breast cancer trials have shown that the benefit of ribociclib plus endocrine therapy in the first-line setting extends to most intrinsic molecular subtypes and is consistent across multiple subgroups. The studies were presented at the 2021 San Antonio...
RxPONDER Update Explores Benefit of Chemotherapy in Subgroups
Updated results of the SWOG S1007 RxPONDER trial confirmed the key takeaway from the previous analysis: adjuvant chemotherapy benefits premenopausal women but not postmenopausal women with hormone receptor–positive, HER2-negative disease, one to three positive lymph nodes, and a 21-gene Oncotype DX ...
Dual Checkpoint Inhibitor Therapy Elicits Responses in Highly Mutated Breast Cancer
Patients with advanced HER2-negative metastatic breast cancer and high tumor mutational burden achieved responses—often durable—from treatment with the immunotherapy doublet of nivolumab and ipilimumab, according to the results of the phase II NIMBUS trial reported at the 2021 San Antonio Breast...
Identifying Women With Triple-Negative Breast Cancer Who May Benefit From Pembrolizumab Plus Chemotherapy
Results of the phase III randomized KEYNOTE-355 trial showed that the addition of the PD-1 inhibitor pembrolizumab to investigator’s choice of first-line chemotherapy improved progression-free and overall survival in women with metastatic triple-negative breast cancer compared with placebo and...
KEYNOTE-522: Sensitivity Analyses Confirm Value of Neoadjuvant Pembrolizumab in Triple-Negative Breast Cancer
Updated results from the pivotal KEYNOTE-522 trial have confirmed the benefit of neoadjuvant therapy with pembrolizumab plus chemotherapy in patients with early triple-negative breast cancer.1 The results were presented at the 2021 San Antonio Breast Cancer Symposium by Peter Schmid, MD, PhD,...
Datopotamab Deruxtecan Shows Activity in Advanced Triple-Negative Breast Cancer
Datopotamab deruxtecan, an antibody-drug conjugate directed against trophoblast cell surface antigen-2 (Trop-2), is showing activity as a treatment for relapsed or refractory advanced triple-negative breast cancer, according to early findings from the phase I TROPION-PanTumor01 trial presented...
Clinical Trials Underway for T-DXd in Breast Cancer
The current standard of care for the neoadjuvant treatment of HER2-positive early-stage breast cancer consists of trastuzumab plus pertuzumab and polychemotherapy. But some patients, particularly those with locally advanced or inflammatory disease, still relapse and die. Furthermore, multiagent...
T-DXd Shows Activity in HER2-Low, HER2-Undetectable Breast Cancer
The antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) has led to practice changes in previously treated HER2-positive metastatic breast cancer. Most notably, in the DESTINY-Breast03 trial, treatment with T-DXd produced a doubling in 12-month progression-free survival vs...
Second-Line T-DXd Improves Progression-Free Survival Across HER2-Positive Metastatic Breast Cancer Subgroups
The antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) lengthened progression-free survival and improved the objective response rate compared with the antibody-drug conjugate ado-trastuzumab emtansine (T-DM1) after trastuzumab and taxane therapy in women with HER2-positive metastatic...
Highlights From the 2021 San Antonio Breast Cancer Symposium
In its first return to a hybrid model since the COVID-19 pandemic began, the 2021 San Antonio Breast Cancer Symposium (SABCS) brought together researchers, clinicians, industry experts, patients, and advocates from across the globe to present and grapple with new data and important topics in breast ...
Prediction Model for BRCA Mutation–Carrying Status in Asian Patients With Breast Cancer
In a study reported in the Journal of Clinical Oncology, Ang et al developed a model for predicting carrier status of pathogenic variants in BRCA1 or BRCA2 among Asian women with breast cancer. As stated by the investigators: “With the development of poly (ADP-ribose) polymerase [PARP] inhibitors...
Study Investigates the Risk of Breast Cancer Mortality After Late Breast Cancer Recurrence
In a Danish study reported in the Journal of Clinical Oncology, Pedersen et al identified risk of breast cancer mortality among women with breast cancer recurrence at ≥ 10 years after primary diagnosis and found that mortality risk was reduced after late vs early recurrence. Study Details The study ...
KEYNOTE-522: Event-Free Survival With Neoadjuvant and Adjuvant Pembrolizumab in Triple-Negative Breast Cancer
As reported in The New England Journal of Medicine by Peter Schmid, MD, PhD, and colleagues, a preplanned interim analysis of the phase III KEYNOTE-522 trial has shown improved event-free survival with the addition of pembrolizumab to neoadjuvant chemotherapy, followed by adjuvant pembrolizumab, in ...
As a Black Woman, I Knew I Had to Advocate for the Best Breast Cancer Care
When I got the call from the radiology department telling me I had to come back for a follow-up mammogram right before Christmas of 2020, I wasn’t surprised or initially concerned. I have dense breasts, and my first mammogram 2 years earlier had also detected suspicious areas in one of my breasts...
ASCO Updates Guidance on Use of Abemaciclib and Endocrine Therapy in Patients With High-Risk Early Breast Cancer
A rapid update to the ASCO guideline on optimal adjuvant chemotherapy and targeted therapy for early breast cancer provides guidance on the use of the oral cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitor abemaciclib with endocrine therapy in patients with high-risk early breast cancer.1 The...
Single-Cell Spatial Connectivity Analysis Offers ‘Unprecedented’ Information in Breast Cancer
A next-generation technology that focuses on protein expression at the single-cell level has yielded a wealth of information about “spatial connectivity” between cancer cells and their microenvironment. It also provided information on the benefit of adding the immune checkpoint inhibitor...
Meta-Analysis of Aromatase Inhibitors vs Tamoxifen in Premenopausal Women With ER-Positive Early-Stage Breast Cancer Receiving Ovarian Suppression
In a patient-level meta-analysis reported in The Lancet Oncology, researchers from the Early Breast Cancer Trialists’ Collaborative Group found that use of an aromatase inhibitor vs tamoxifen reduced the risk of recurrence in premenopausal women with estrogen receptor (ER)-positive early breast...
Does Daily Aspirin Help Prevent Breast Cancer Recurrence?
Taking aspirin daily does not prevent breast cancer recurrence, according to research presented by Wendy Y. Chen, MD, MPH, a medical oncologist at Dana-Farber Cancer Institute, during the February 2022 ASCO Plenary Series session (Abstract 360922). Results of a double-blind phase III study of more...
Sara A. Hurvitz, MD, on HER2-Positive Metastatic Breast Cancer: T-DXd vs T-DM1
Sara A. Hurvitz, MD, of the University of California, Los Angeles Jonsson Comprehensive Cancer Center, discusses phase III findings from the DESTINY-Breast03 trial, which compared ado-trastuzumab deruxtecan (T-DXd) with standard-of-care trastuzumab emtansine (T-DM1) in patients with HER2-positive metastatic breast cancer. T-DXd showed superior progression-free survival across subgroups of patients previously treated with trastuzumab and a taxane, including those with brain metastases (Abstract GS3-01).
Study Identifies Factors Impacting Adherence to Oral Medications for Metastatic Breast Cancer
A recent study published by Conley et al in Breast Cancer Research and Treatment aimed to evaluate factors that influence the ability of people with metastatic breast cancer to adhere to their prescribed regimen of oral anticancer medication. Researchers found that multiple factors affected...
Concordance for Low HER2 Protein Expression in Breast Cancer Tissue Using Standard Immunohistochemistry Assays
In a study reported in JAMA Oncology, Fernandez et al found that scoring accuracy for low HER2 protein expression (0 or 1+) in breast cancer tissue on standard immunohistochemistry (IHC) assays was poor. As observed by the investigators, the findings pose issues for investigation of fam-trastuzumab ...
RxPONDER Trial: Another Step in Defining Which Patients With Breast Cancer May Be Spared Adjuvant Cytotoxic Chemotherapy
As reported by Kalinsky et al and summarized in this issue of The ASCO Post, an interim analysis of the phase III RxPONDER trial showed that the addition of adjuvant chemotherapy to endocrine therapy improved invasive disease–free survival among premenopausal—but not postmenopausal—women with...
Improved Outcomes With Adjuvant Chemoendocrine vs Endocrine Therapy in Premenopausal Women With Node-Positive Breast Cancer and Recurrence Score ≤ 25
In an interim analysis of a phase III trial (RxPONDER) reported in The New England Journal of Medicine, Kevin Kalinsky, MD, MS, of Winship Cancer Institute, and colleagues found that the addition of adjuvant chemotherapy to endocrine therapy improved invasive disease–free survival among...
Expert Point of View: Charles Shapiro, MD
Charles Shapiro, MD, Professor of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, commented on the study findings. “MA.32 is a large, randomized placebo-controlled trial of metformin in over 3,600 women with invasive breast cancer. The rationale for...
Metformin Added to Standard Adjuvant Chemotherapy Fails to Improve Outcomes in Early Breast Cancer
The addition of metformin, a drug commonly used to treat type 2 diabetes, to standard adjuvant treatment failed to improve invasive disease–free survival or overall survival for hormone receptor–positive or –negative breast cancer, according to the results of a large landmark trial led by the...
Expert Point of View: Angela DeMichele, MD, MSCE
Angela DeMichele, MD, MSCE, the Alan and Jill Miller Professor in Breast Cancer Excellence at the Perelman School of Medicine of the University of Pennsylvania in Philadelphia, commented on NIMBUS1 for The ASCO Post. She said obtaining information on tumor mutational burden is simple, as it is part ...
Dual Checkpoint Inhibitor Therapy Elicits Responses in Highly Mutated Breast Cancer
Patients with advanced HER2-negative metastatic breast cancer and high tumor mutational burden achieved responses—often durable—from treatment with the immunotherapy doublet of nivolumab and ipilimumab, according to results of the phase II NIMBUS trial reported at the 2021 San Antonio Breast Cancer ...
Expert Point of View: Debu Tripathy, MD, and Hope S. Rugo, MD, FASCO
The ASCO Post asked Debu Tripathy, MD, Professor and Chair of Medical Breast Oncology at The University of Texas MD Anderson Cancer Center, Houston, and Hope S. Rugo, MD, FASCO, Professor of Medicine, Director of Breast Oncology and Clinical Trials Education at the University of California San...
Datopotamab Deruxtecan Shows Activity in Advanced Triple-Negative Breast Cancer
Datopotamab deruxtecan, an antibody-drug conjugate directed against trophoblast cell surface antigen-2 (Trop-2), is showing promise as a treatment for relapsed or refractory advanced triple-negative breast cancer, according to early findings from the phase I TROPION-PanTumor01 trial presented...
Expert Point of View: Anne Blaes, MD
Invited discussant Anne Blaes, MD, of the University of Minnesota, Minneapolis, emphasized the main takeaway finding of the combined updated analysis of the SOFT and TEXT trials. “In early-stage estrogen receptor–positive breast cancer, premenopausal women who don’t require chemotherapy do very...
Evidence Supports Ovarian Function Suppression Plus Aromatase Inhibitor in Premenopausal Women With Early Breast Cancer
The benefits of ovarian function suppression were sustained long term for premenopausal women with hormone receptor–positive breast cancer, according to updates from SOFT and TEXT, two randomized, controlled trials, presented at the 2021 San Antonio Breast Cancer Symposium.1 A separate large...
Expert Point of View: Hope S. Rugo, MD, FASCO
The discussant of KEYNOTE-522 at the 2021 San Antonio Breast Cancer Symposium, Hope S. Rugo, MD, FASCO, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education at the University of California San Francisco Comprehensive Cancer Center, commented: “We are clearly making...
KEYNOTE-522: Sensitivity Analyses Confirm Value of Neoadjuvant Pembrolizumab in Triple-Negative Breast Cancer
Updated results from the pivotal KEYNOTE-522 trial have confirmed the benefit of neoadjuvant therapy with pembrolizumab plus chemotherapy in patients with early triple-negative breast cancer.1 The results were presented at the 2021 San Antonio Breast Cancer Symposium by Peter Schmid, MD, PhD,...
PALLAS Trial in Hormone Receptor–Positive, HER2-Negative Breast Cancer: Defining the Role of Adjuvant CDK4/6 Inhibition
Over the past 7 years, the introduction of combined endocrine therapy with cyclin-dependent kinase (CDK) 4/6 inhibitors resulted in a dramatic improvement in outcomes for patients with metastatic, hormone receptor–positive, HER2-negative breast cancer. Early attempts to modulate the cell cycle with ...
PALLAS Trial: No Invasive Disease–Free Survival Benefit With Addition of Adjuvant Palbociclib to Endocrine Therapy in Early Breast Cancer
As reported in the Journal of Clinical Oncology by Michael Gnant, MD, of the Comprehensive Cancer Center, Medical University of Vienna, and colleagues, the final analysis of the phase III PALLAS trial has shown no invasive disease–free survival benefit with the addition of adjuvant palbociclib to...
Compression Sleeves to Reduce Risk of Arm Swelling in Women Undergoing Surgery for Breast Cancer
In an Indian single-center study reported in the Journal of Clinical Oncology, Paramanandam et al found that the prophylactic use of compression sleeves reduced the risk of arm swelling in women with breast cancer undergoing axillary lymph node dissection. Study Details In the study, 301 evaluable...
Can An Intelligent Vacuum-Assisted Biopsy Algorithm Reliably Identify Patients With Breast Cancer Who Have a Pathologic Complete Response to Neoadjuvant Therapy?
In a study reported in the Journal of Clinical Oncology, Pfob et al developed a machine learning algorithm–based (intelligent) vacuum-assisted biopsy model that could identify patients with pathologic complete response (ypT0 and ypN0) to neoadjuvant therapy for breast cancer who may be able to...
Association of Breast Cancer Subtypes With Pathogenic Germline Variants in Nine Breast Cancer Susceptibility Genes
In a study reported in JAMA Oncology, researchers from the Breast Cancer Association Consortium found that pathogenic germline variants in nine breast cancer susceptibility genes were associated with different breast cancer subtypes, although most were also associated with triple-negative disease....
Predictive Model for Severe Fatigue After Breast Cancer Diagnosis
In a study reported in the Journal of Clinical Oncology, Di Meglio et al developed a predictive model for severe fatigue after a diagnosis of breast cancer. Study Details The study involved data on patients with stage I to III breast cancer included in the prospective multicenter CANcer TOxicity...
Role of CECR2 Gene in Advanced Triple-Negative Breast Cancer
A new study published by Zhang et al in Science Translational Medicine shows inhibition of the CECR2 gene may prevent triple-negative breast cancer from advancing or metastasizing. The discovery is an early step in finding new therapeutics for triple-negative breast cancer, one of the most...
Pyrotinib and Capecitabine in HER2-Positive Breast Cancer With Brain Metastases
In the Chinese phase II PERMEATE trial reported in The Lancet Oncology, Yan et al found that the combination of the pan-HER receptor tyrosine kinase inhibitor pyrotinib plus capecitabine produced high intracranial response rates in women with HER2-positive breast cancer and brain metastases,...
Use of Autologous Metastasis Mutation–Reactive TILs in Metastatic Breast Cancer
In a National Institutes of Health study reported in the Journal of Clinical Oncology, Zacharakis et al found that treatment with autologous tumor-infiltrating lymphocytes (TILs) reactive to mutations in metastatic lesions produced responses in patients with metastatic breast cancer. Study Details...
