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Breast Cancer

Combined Use of Identification Methods for Dense Breasts and Discussion of Supplemental Imaging

In a study reported in JAMA Internal Medicine, Karla ­Kerlikowske, MD, and colleagues found that the combined use of Breast Imaging Reporting and Data System (BI-RADS) breast density and Breast Cancer Surveillance Consortium (BCSC)-defined risk for breast cancer may be an effective way of...

Breast Cancer

Alpelisib for PIK3CA-Mutated Advanced Breast Cancer

On May 24, 2019, alpelisib was approved for use in combination with fulvestrant for postmenopausal women, and men, with hormone receptor–positive, HER2-negative, PIK3CA-mutated advanced or metastatic breast cancer, as detected by a U.S. Food and Drug Administration (FDA)-approved test following...

Breast Cancer

Insightful Advice From a College Advisor Leads to an Unexpected Career in Oncology

For this installment of the Living a Full Life series, guest editor Jame Abraham, MD, FACP, spoke with Tatiana M. Prowell, MD, who currently serves as Associate Professor of Oncology in the Breast Cancer Program at the Johns Hopkins Kimmel Comprehensive Cancer Center and as a Medical Officer and...

Breast Cancer

Menopausal Hormone Therapy Use and Risk of Breast Cancer

In a study reported in The Lancet, the Collaborative Group on Hormonal Factors in Breast Cancer found that the use of menopausal hormone therapy is associated with an increased risk of breast cancer, with risk increasing as the duration of use increases, in both current and past users. Study...

Breast Cancer
Survivorship

Pregnancy Appears Safe After Treatment for Breast Cancer in Patients With BRCA Mutations

Pregnancy after breast cancer appears to be safe in patients with germline BRCA mutations—and particularly among those with BRCA1 mutations—according to new research. Limited data are available on the safety of pregnancy and reproductive outcomes in patients with breast cancer and BRCA mutations,...

Breast Cancer

Neoadjuvant Talazoparib for Operable BRCA-Mutated Breast Cancer

In a study reported in the Journal of Clinical Oncology, Jennifer K. Litton, MD, and colleagues found that 6 months of neoadjuvant talazoparib therapy resulted in a high rate of residual cancer burden (RCB) of 0 (pathologic complete response) in patients with stage I–III breast cancer with germline ...

Breast Cancer

Pyrotinib or Lapatinib With Capecitabine in Previously Treated HER2-Positive Metastatic Breast Cancer

In a Chinese phase II trial reported in the Journal of Clinical Oncology by Ma et al, the combination of the pan-ErbB inhibitor pyrotinib and capecitabine improved response rate vs lapatinib/capecitabine in women with HER2-positive relapsed or metastatic breast cancer previously treated with...

Breast Cancer
Issues in Oncology

FDA Issues Draft Guidance Encouraging Inclusion of Male Patients in Breast Cancer Clinical Trials

A draft guidance issued by the U.S. Food Drug Administration (FDA) on August 26 includes draft recommendations for the inclusion of male patients in breast cancer clinical trials. Historically, males either have not been included in clinical trials for drugs to treat breast cancer, or inclusion of...

Breast Cancer

Tumor Size and Grade Matter, and Ovarian Ablation by Chemotherapy May Explain Subgroup Anomaly in TAILORx

At the 2019 ASCO Annual Meeting, and simultaneously in The New England Journal of Medicine, we heard the third paper reporting results from TAILORx.1,2 The first, in 2015,3 indicated that women with node-negative breast cancers with Oncotype DX recurrence scores less than 11 did extremely well...

Breast Cancer

Expert Point of View: Carla S. Fisher, MD

CARLA S. FISHER, MD, Medical Director of Breast Surgical Oncology and Associate Professor of Surgery at Indiana University School of Medicine, Indianapolis, commented on the study that sought to identify HER2- positive patients who do, and do not, need surgery after neoadjuvant chemotherapy. “As...

Breast Cancer

Can Some Women With HER2-Positive Breast Cancer Forgo Surgery?

Breast cancer researchers at The University of Texas MD Anderson Cancer Center, Houston, are beginning to select patients with HER2-positive breast cancer who might forgo surgery after neoadjuvant chemotherapy. While this fine-tuning is currently intended to inform clinical trials—in particular, to ...

Breast Cancer

Almost 20 Years Later, Breast Fitness Is More Relevant Than Ever

BOOKMARK Title: Breast Fitness: An Optimal Exercise and Health Plan for Reducing Your Risk of Breast CancerAuthors: Anne McTiernan, MD, PhD; Julie Gralow, MD; and Lisa TalbottPublisher: St. Martin’s PressPublication Date: October 2000 (first edition)Price: $48.75, hardcover, 352 pages   The...

breast cancer
gynecologic cancer

USPSTF Recommendation on Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer

As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF) recommended risk assessment and, if indicated, genetic counseling and testing for potentially harmful BRCA1/2 mutations in women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have...

breast cancer

Total Cumulative Chemotherapy Dose and Survival in Breast Cancer

Physicians should attempt to maintain full doses of chemotherapy, especially early in the course of treatment, for patients with intermediate- or high-risk breast cancer, according to research published by Veitch et al in JNCCN—Journal of the National Comprehensive Cancer Network. The...

breast cancer

Neoadjuvant Letrozole Plus Taselisib or Placebo in Postmenopausal Women With ER-Positive, HER2-Negative Early Breast Cancer

In the phase II LORELEI trial reported in The Lancet Oncology, Saura et al found that the addition of the phosphatidylinositol-3 kinase (PI3K) inhibitor taselisib to neoadjuvant letrozole improved objective response rates but not pathologic complete response rates in women with estrogen receptor...

breast cancer

Circulating Tumor DNA and Relapse in Early-Stage Breast Cancer

In a study reported in JAMA Oncology, Garcia-Murillas et al found that detection of circulating tumor DNA (ctDNA) during follow-up after initial treatment for early breast cancer was associated with a high risk of relapse. Detection at diagnosis was also associated with poorer relapse-free...

breast cancer
colorectal cancer
head and neck cancer
lung cancer

FDA Approves Entrectinib for NTRK-Fusion Cancers, ROS1-Positive NSCLC

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to entrectinib (Rozlytrek) for adult and adolescent patients whose cancers have an NTRK (neurotrophic tyrosine receptor kinase) genetic fusion and for whom there are no effective treatments. Entrectinib was also...

breast cancer
survivorship

Adiposity Distribution and Risk for Cardiovascular Disease Among Breast Cancer Survivors

In a study reported in the Journal of Clinical Oncology, Cespedes Feliciano et al found that increased visceral and intramuscular adiposity were associated with increased risk of cardiovascular disease among breast cancer survivors, independent of baseline risk factors and cancer treatment. Study...

breast cancer

Circulating Tumor DNA Analysis for Detection of Residual Disease in Breast Cancer

Researchers have developed a new method for tracking residual disease in patients with breast cancer that could one day help doctors better tailor treatments and prevent unnecessary surgeries for some people with the disease. Findings were published by McDonald et al in Science Translational...

Breast Cancer
Genomics/Genetics

How Laura J. van ’t Veer, PhD, Became an Expert in Genetic Testing for Breast Cancer

Breast cancer researcher and innovator Laura J. van ’t Veer, PhD, was born and reared in Amsterdam in 1957. “During high school, I had a wonderful biology teacher who was going through his own biology studies at the University of Amsterdam, and he was bringing that university-level education into...

Breast Cancer
Kidney Cancer
Sarcoma
Lymphoma
Multiple Myeloma

Notable Presentations at ASCO 2019 Included Studies in Sarcoma, Lymphoma, Myeloma, and Breast and Kidney Cancers

The 2019 ASCO Annual Meeting featured a wealth of presentations on important topics. In addition to our regular news coverage of the meeting, we present below some highlights of other studies that add to our knowledge base for treatment of various cancers. Olaratumab in Soft-Tissue Sarcoma...

breast cancer
cost of care

How Treatment Costs Affect Decisions for Breast Cancer Surgery

In a study reported in the Journal of Oncology Practice, Greenup et al found that cancer treatment costs influenced women’s decisions on breast cancer surgery. Researchers reported many women, even at the highest income levels, said that costs were higher than expected, and that most women...

breast cancer

AI May Improve Efficiency and Accuracy of Digital Breast Tomosynthesis

Artificial intelligence (AI) may improve the efficiency and accuracy of an advanced imaging technology used to screen for breast cancer, according to a study published by Conant et al in Radiology: Artificial Intelligence. Digital breast tomosynthesis is an advanced method for cancer...

breast cancer

Ten-Year Update on Standard Adjuvant Chemotherapy vs Capecitabine in Older Women With Early Breast Cancer

As reported in the Journal of Clinical Oncology by Muss et al, long-term findings from the phase III CALGB 49907 trial support the finding from the primary analysis—that standard adjuvant chemotherapy improved recurrence-free survival vs capecitabine in women aged 65 years or older with early ...

breast cancer

Overall Survival With the Addition of Ribociclib to Endocrine Therapy in Advanced HR-Positive, HER2-Negative Breast Cancer

As reported in The New England Journal of Medicine by Im et al, an interim analysis of the phase III MONALEESA-7 trial has shown an overall survival benefit with the addition of the cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor ribociclib to endocrine therapy in pre- or perimenopausal women...

breast cancer
global cancer care

Automated Breast Cancer Detection Assay Using Fine-Needle Aspiration May Aid Patients in Developing Countries

A new laboratory test developed to identify chemical changes to a group of cancer-related genes may be able to accurately detect which breast tumors are cancerous or benign. Such a test could result in a more timely diagnosis of breast cancer for women in developing countries with less access to...

breast cancer

Use of BI-RADS Breast Density and BCSC Risk to Identify Women for Discussion of Supplemental Imaging

In a study reported in JAMA Internal Medicine, Kerlikowske et al found that the combined use of Breast Imaging Reporting and Data System (BI-RADS) breast density and Breast Cancer Surveillance Consortium (BCSC)-defined risk for breast cancer may be an effective way of identifying women with dense...

Breast Cancer

Expert Point of View: Mark Pegram, MD, and Sandra Swain, MD, FASCO

Mark Pegram, MD, the Susy Yuan-Huey Hung Professor of Medical Oncology and Director of the Stanford Breast Oncology Program, said the Dana-Farber study “independently confirms that HER2 heterogeneity is a distinct clinical entity with lower levels of HER2 expression and pathologic complete...

Breast Cancer

Is Heterogeneity Within HER2-Positive Tumors Clinically Relevant?

Breast cancers that display heterogeneity of HER2 expression may represent a distinct subset of HER2-positive breast cancer that is associated with lower rates of pathologic complete response, according to a phase II study from Dana-Farber Cancer Institute. This trial evaluated HER2 heterogeneity...

Breast Cancer
Immunotherapy

Two Pivotal Studies in Breast Cancer Report Further Analyses

At the 2019 ASCO Annual Meeting, two pivotal breast cancer trials reported final or additional analyses: one confirmed the negative results seen in earlier reports,1 and the other supported a new survival benchmark.2 KRISTINE: Neoadjuvant T-DM1/Pertuzumab Sara A. Hurvitz, MD, of the David Geffen...

breast cancer

Timing of Postoperative Treatment After Diagnosis of Breast Cancer and Survival

When chemotherapy is recommended as part of a treatment plan, women with breast cancer should start postoperative treatment ideally within 4 months of their cancer diagnosis. New study findings published by Kupstas et al in the Annals of Surgical Oncology show delaying chemotherapy further is...

breast cancer
symptom management

Neoadjuvant Chemotherapy Duration and Obesity May Be Associated With Increased Risk of Lymphedema in Some Women With Breast Cancer

In a cohort study reported in JAMA Surgery, Armer et al found that longer duration of neoadjuvant chemotherapy and increasing body mass index (BMI) were associated with increased risk of lymphedema in women with node-positive breast cancer who received neoadjuvant chemotherapy and axillary...

breast cancer
symptom management

Metabolic Changes May Signal Development of Chemotherapy-Associated Cardiotoxicity

To learn more about the processes that lead to chemotherapy-associated cardiotoxicity, a team of researchers at Beth Israel Deaconess Medical Center (BIDMC) conducted a study to investigate whether early changes in energy-related metabolites in the blood—measured shortly after...

breast cancer

Role of Regulatory T Cells in Predicting Breast Cancer Relapse

Blood and intratumoral regulatory T-cell activity may one day provide a method for predicting breast cancer relapse, according to findings published by Wang et al in Nature Immunology. “This is the first success linking a solid tumor with blood biomarkers—an indicator of whether a...

breast cancer
survivorship

Intervention to Promote Breast Cancer Surveillance in Childhood Cancer Survivors Who Received Chest Radiotherapy

In the EMPOWER trial, which took place within the larger Childhood Cancer Survivor Study (CCSS) and was reported in the Journal of Clinical Oncology, Oeffinger et al found that an intervention consisting of mailed educational materials followed by telephone-delivered counseling led to an increased...

Breast Cancer
Gastroesophageal Cancer
Gastrointestinal Cancer

FDA Approves New Trastuzumab Biosimilar

On June 14, the U.S. Food and Drug Administration (FDA) approved trastuzumab-anns (Kanjinti) for all approved indications of the reference product trastuzumab (Herceptin): for the treatment of HER2-overexpressing breast cancer and HER2-overexpressing metastatic gastric or gastroesophageal junction...

breast cancer
issues in oncology

Does Radioactive Iodine Treatment for Hyperthyroidism Increase the Risk of Cancer Mortality?

Findings from a study of patients who received radioactive iodine treatment for hyperthyroidism show a modest association between the dose of treatment and long-term risk of death from solid cancers, including breast cancer. The study, led by researchers at the National Cancer Institute (NCI), was...

breast cancer
survivorship

Mortality After Breast Cancer Among Childhood Cancer Survivors

In an analysis from the Childhood Cancer Survivor Study (CCSS) reported in the Journal of Clinical Oncology, Moskowitz et al found a significant increase in overall mortality among childhood cancer survivors who developed breast cancer vs matched controls. A numeric increase in breast cancer...

Breast Cancer
Immunotherapy

SOPHIA Trial Tests Margetuximab in Heavily Pretreated Patients With HER2-Positive Metastatic Breast Cancer

In the phase III SOPHIA trial of 536 heavily pretreated patients with HER2-positive metastatic breast cancer, the novel anti-HER2 antibody margetuximab plus chemotherapy led to significant improvements in progression-free survival, response, and clinical benefit compared with...

Breast Cancer

NALA Trial: Neratinib Plus Capecitabine Shows Benefit in Metastatic Breast Cancer

In the global phase III NALA trial, treatment of metastatic HER2-positive breast cancer with neratinib plus capecitabine significantly improved progression-free survival, delayed the time to intervention for central nervous system disease, and showed a trend toward improved overall survival vs...

Breast Cancer

Clinical Risk Enhances Utility of TAILORx Findings in Young Women With Breast Cancer

Clinical risk factors add prognostic information that complements the 21-gene recurrence score, according to a new analysis from the landmark TAILORx trial.1,2 The integration of clinical risk with the recurrence score provides greater precision in determining recurrence risk and guiding the use of ...

Breast Cancer

CLEOPATRA End-of-Study Analysis in Metastatic Breast Cancer: 37% Alive at 8 Years

The end-of-study analysis of the landmark CLEOPATRA trial shows that 37% of patients with HER2-positive metastatic breast cancer are still alive at 8 years, according to principal investigator Sandra M. Swain, MD, FACP, FASCO, Associate Dean for Research Development at Georgetown University Medical ...

breast cancer

Breast Cancer Screening With Addition of MRI to Mammography in Women With Familial Risk

The Dutch FaMRIsc study, reported in The Lancet Oncology by Saadatmand et al, found that the addition of screening magnetic resonance imaging (MRI) to mammography resulted in identification of more breast cancers—and identification at an earlier stage—vs mammography alone among women...

breast cancer

Final Analysis of the PHARE Trial: 6 Months vs 12 Months of Adjuvant Trastuzumab in HER2-Positive Breast Cancer

In the French phase III PHARE trial reported in The Lancet, Pivot et al found that noninferiority of 6 months vs 12 months of adjuvant trastuzumab combined with standard chemotherapy could not be demonstrated for disease-free survival in HER2-positive early breast cancer. An earlier interim...

breast cancer
immunotherapy

Niraparib Plus Pembrolizumab in Advanced Triple-Negative Breast Cancer

In the phase II TOPACIO/KEYNOTE-162 trial reported in JAMA Oncology, Vinayak et al found evidence of activity of combined niraparib and pembrolizumab in a cohort of patients with advanced or metastatic triple-negative breast cancer, with higher response rates seen in patients with BRCA mutations or ...

Breast Cancer

Evidence Lacking That Denosumab Alters the Course of Breast Cancer

I am writing to provide personal context to my column on adjuvant denosumab or bisphosphonates for resected breast cancer, which appears on page 52 in this issue of The ASCO Post. I have been upset since 2013 that adjuvant zoledronate has been recommended for women with breast cancer onset after...

Breast Cancer

Denosumab Prevents Neither Breast Cancer Relapse Nor Death

The recently published report of Austrian Breast and Colorectal Cancer Study Group’s Study 18 (ABCSG-18)1 for the secondary endpoint of disease-free survival suggests that denosumab given in a low dose of 60 mg subcutaneously every 6 months during aromatase inhibitor adjuvant therapy is...

breast cancer
issues in oncology

AACR Environmental Carcinogenesis: Study Finds Environmental Quality Linked With Distant/Metastatic Breast Cancer Risk

Although many risk factors increase a woman’s chance of developing breast cancer—including genetic and hormonal causes—there is increasing evidence suggesting an environmental link. A study investigating the effects of the cumulative environmental quality on aggressive breast...

breast cancer

Personalized Assay May Aid in Determining Risk of Recurrence of Triple-Negative Breast Cancer

Sixty percent of patients with triple-negative breast cancer will survive more than 5 years without disease after standard treatment, but 4 out of 10 women will have a rapid recurrence of the disease. There are currently no clinical tests to assess an individual patient’s prognosis, so all...

breast cancer

PERSEPHONE: 4-Year Disease-Free Survival With 6 vs 12 Months of Adjuvant Trastuzumab for HER2-Positive Breast Cancer

The 4-year disease-free survival results of the UK phase III PERSEPHONE trial, reported by Earl et al in The Lancet, found that 6 months of adjuvant trastuzumab was noninferior to 12 months when given with chemotherapy in HER2-positive early breast cancer. Study Details The open-label trial...

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