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Results of a planned interim overall survival analysis of the phase III monarchE trial offer further support for the addition of abemaciclib to adjuvant endocrine therapy for patients with hormone receptor–positive, HER2-negative, node-positive, high-risk breast cancer, according to Stephen R.D....
Andrea De Censi, MD, PhD, of Italy’s E.O. Ospedali Galliera, discusses phase III findings showing that low-dose tamoxifen (so-called babytam) given for 3 years still significantly prevents recurrences from noninvasive breast cancer after a median of 7 years from treatment cessation. Babytam at 5 mg/d for 3 years significantly lowered recurrence from noninvasive breast cancer at 10 years without “excess” adverse events (Abstract GS4-08).
Ann H. Partridge, MD, MPH, of Dana-Farber Cancer Institute, discusses results from the POSITIVE trial, which showed that a temporary interruption of endocrine therapy in women with hormone-responsive breast cancer in order to attempt pregnancy, does not affect short-term disease outcomes. The study found that 74% of women had at least one pregnancy, most (70%) within 2 years. Birth defects were low (2%) and were not clearly associated with treatment exposure. Dr. Partridge explains that these data stress the need to incorporate patient-centered reproductive health care in the treatment and follow-up of young women with breast cancer (Abstract GS4-09).
Mafalda Oliveira, MD, PhD, of Spain’s Vall d’Hebron University Hospital and Institute of Oncology, discusses findings from the SERENA-2 trial, which compared the next-generation selective estrogen receptor degrader camizestrant to fulvestrant in patients with hormone receptor–positive, HER2-negative breast cancer. Camizestrant, which can be taken as a daily pill (as opposed to fulvestrant, which must be given via injection), improved progression-free survival by up to 42% (Abstract GS3-02).
In a new survey, a majority (64%) of patients diagnosed with breast cancer younger than 46 years reported significant impacts to their sexual health, yet 86% of patients reported that their health-care provider was unable to help address sexual health issues, according to findings presented by...
Marleen Kok, MD, PhD, of the Netherlands Cancer Institute, discusses the most important advances in early breast cancer treatment during the past year for patients with triple-negative, HER2-positive, and estrogen receptor–positive disease. Dr. Kok also addresses long-term treatment toxicities and quality of life.
François-Clément Bidard, MD, PhD, of the Institut Curie, discusses overall survival results from the STIC CTC trial. To guide the choice between chemotherapy and endocrine therapy for patients with metastatic, estrogen receptor–positive/HER2-negative breast cancer, researchers compared circulating tumor cell (CTC) count to physician’s choice of treatment. The data suggest that the CTC count resulted in better long-term outcomes (Abstract GS3-09).
Erica L. Mayer, MD, PhD, of Dana-Farber Cancer Institute, discusses findings from the PACE study of patients with endocrine- and CDK4/6 inhibitor–pretreated estrogen receptor–positive/HER2-negative metastatic breast cancer who were randomly assigned to fulvestrant alone; fulvestrant and palbociclib; or fulvestrant, palbociclib, and avelumab. Combining palbociclib with fulvestrant beyond disease progression on a prior CDK4/6 inhibitor regimen did not improve progression-free survival compared with fulvestrant alone. A longer progression-free survival when a PD-L1 inhibitor was added to fulvestrant and palbociclib deserves further study. A baseline circulating tumor DNA analysis suggests that the potential benefit of palbociclib after progression on a prior CDK4/6 inhibitor may be influenced by ESR1 or PIK3CA status (Abstract GS3-06).
Aditya Bardia, MD, MPH, of Massachusetts General Hospital, discusses results from the phase III EMERALD trial, the first study to demonstrate improved progression-free survival vs standard of care in estrogen receptor (ER)-positive, HER2-negative metastatic breast cancer with one to two prior lines of endocrine treatment, with or without one line of chemotherapy. This finding applied to all patients in the study, including the subgroup with ESR1 mutations (Abstract GS3-01).
Per Karlsson, MD, PhD, of Sweden’s University of Gothenburg and the Sahlgrenska Comprehensive Cancer Center, discusses results from the POLAR study, which was a meta-analysis of three clinical trials of breast-conserving surgery with or without radiotherapy. POLAR is the first genomic classifier that appears not only to be prognostic for locoregional recurrence, but also predictive of radiotherapy benefit. Although patients with breast cancer who had a high POLAR score benefited from radiotherapy, patients with a low score did not, and may be candidates for omission of radiotherapy after breast-conserving surgery (Abstract GS4-03).
Elacestrant—an investigational oral selective estrogen receptor degrader (SERD)—achieved longer progression-free survival vs standard-of-care endocrine monotherapy as second- or third-line therapy in patients with estrogen receptor (ER)-positive, HER2-negative, advanced or metastatic breast cancer...
Chemotherapy followed by endocrine therapy led to more cancer-related cognitive impairment compared with endocrine therapy alone in patients with hormone receptor–positive, HER2-negative breast cancer at 36 months, according to patient-reported responses. These findings—from a substudy of the phase ...
Patients with invasive breast cancer who had low scores on an investigational gene molecular signature had similar rates of local recurrence independent of whether they received adjuvant radiation therapy after breast-conserving surgery, according to findings presented by Karlsson et al at the 2022 ...
Patients with multiple tumors in a single breast who underwent a lumpectomy followed by radiation therapy had local recurrence rates comparable to those historically observed in patients with a single tumor, according to new findings presented by Judy C. Boughey, MD, and colleagues at the 2022 San...
“Pregnancy confers a dual effect” on breast cancer risk, “with an initial transient increased risk for breast cancer that is followed by long-term protection over time,” Luis Zabala Blanco, Jr, MD, noted in an update on the pathology of pregnancy-associated breast cancer, which was presented at the ...
Lisa A. Carey, MD, and Joannie M. Ivory, MD, MSPH, both of the University of North Carolina at Chapel Hill, discuss the higher frequency and treatment implications of nonluminal A or high-risk tumors in Black and younger women. In this study, PAM50 and 21-gene assays revealed different demographic patterns by race and age (Abstract PD1-08).
Mariana Chavez-MacGregor, MD, MSc, of The University of Texas MD Anderson Cancer Center, discusses phase III results from the SWOG S1207 trial which was designed to evaluate the role of adjuvant everolimus in combination with adjuvant endocrine therapy among patients with high-risk, hormone receptor–positive, HER2-negative early-stage breast cancer. Adding everolimus did not improve invasive disease–free or overall survival and was associated with high rates of adverse events (Abstract GS1-07).
Nicholas C. Turner, MD, PhD, of London’s Institute of Cancer Research and The Royal Marsden, discusses phase III results from the CAPItello-291 clinical trial, which showed that in patients with hormone receptor–positive, HER2-negative tumors resistant to aromatase inhibitors, adding the investigational AKT inhibitor capivasertib to fulvestrant doubled the median progression-free survival compared with placebo plus fulvestrant (Abstract GS3-04).
Joseph A. Sparano, MD, of the Tisch Cancer Center at Mount Sinai Health System, discusses long-term clinical outcomes data that continue to show many women with early breast cancer can safely forgo chemotherapy, when guided by the 21-gene recurrence score result. The longer follow-up also showed that recurrences of breast cancer continue to occur years after the original diagnosis, although these recurrences were not prevented by chemotherapy use. Racial disparities were not explained by inequities in social determinants of health or treatment adherence, with Black women at higher risk of early recurrence within the first 5 years of diagnosis, but not later recurrence after 5 years (Abstract GS1-05).
The use of circulating tumor cell counts to guide the choice between chemotherapy and endocrine therapy as first-line treatment for patients with metastatic, estrogen receptor–positive, HER2-negative breast cancer provided overall survival benefits compared with physician’s choice of treatment,...
The next-generation selective estrogen receptor degrader (SERD) camizestrant improved progression-free survival compared to fulvestrant in patients with hormone receptor–positive, HER2-negative breast cancer, according to results from the phase II SERENA-2 trial presented by Mafalda Oliveira, MD,...
Patients with breast cancer who paused their endocrine therapy while attempting to conceive experienced short-term rates of breast cancer recurrence similar to patients with breast cancer who did not pause their therapy for pregnancy—and many of them went on to conceive and deliver healthy babies,...
In patients with hormone receptor–positive, HER2-negative breast cancer who are resistant to aromatase inhibitors, the addition of the investigational AKT inhibitor capivasertib to fulvestrant doubled the median progression-free survival compared with placebo plus fulvestrant, according to results...
An exploratory analysis of KEYNOTE-522, which established the benefit of neoadjuvant pembrolizumab plus chemotherapy in triple-negative breast cancer, has now provided data to further describe prognosis and possibly guide treatment.1 In the study, presented at the 2022 ASCO Annual Meeting,...
Sara A. Hurvitz, MD, of the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, discusses phase II results from the TRIO-US B-12 TALENT study, which showed that patients with localized, hormone receptor–positive, HER2-low breast cancer who are treated with fam-trastuzumab deruxtecan-nxki (T-DXd) in the neoadjuvant setting had an overall response rate (ORR) of 68%. When combined with anastrozole, T-DXd led to a 58% ORR. This is the first trial to evaluate T-DXd in HER2-low breast cancer, a potentially curable disease (Abstract GS2-03).
Sara A. Hurvitz, MD, of the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, discusses phase III findings from the DESTINY-Breast03 study, which showed that second-line treatment with fam-trastuzumab deruxtecan-nxki (T-DXd) led to longer overall survival compared with ado-trastuzumab emtansine (T-DM1) in patients with HER2-positive metastatic breast cancer. Patients treated with T-DXd had a 36% lower risk of death than those treated with T-DM1 (Abstract GS2-02).
The HER3-directed antibody-drug conjugate patritumab deruxtecan (HER3-DXd) showed activity in patients with heavily pretreated HER3-expressing metastatic breast cancer in a phase I/II study. Ian E. Krop, MD, PhD, Associate Director, Yale Cancer Center, New Haven, Connecticut, presented these...
Molecular testing and genomic testing are now considered standard of care in breast cancer, guiding treatment decisions in early breast cancer and targeted therapies in the metastatic setting. “But tumors evolve,” Virginia Kaklamani, MD, DSc, reminded participants at the 2022 Lynn Sage Breast...
Ruth O’Regan, MD, of the University of Rochester Medical Center, discusses the Breast Cancer Index (BCI), a genomic assay that can assess the risk of late distant recurrence (5–10 years after diagnosis) of hormone receptor–positive, early-stage breast cancer. Among premenopausal women with this disease who were enrolled in the SOFT trial, those with a high BCI score had an increased risk of distant recurrence. Those with a low BCI score benefited more from the addition of ovarian suppression therapy to endocrine therapy after 12 years of follow-up (Abstract GS1-06).
Yara Abdou, MD, of the University of North Carolina, discusses results from the RxPONDER SWOG S1007 study, which showed that non-Hispanic Black women with hormone receptor–positive/HER2-negative breast cancer with one to three involved lymph nodes and a recurrence score of ≤ 25 have worse outcomes than non-Hispanic White women. In addition, Black patients were more likely to accept treatment assignment than their White counterparts and were just as likely to remain on estrogen therapy at 6 and 12 months, suggesting that outcome differences may be less likely attributable to lack of treatment compliance within the first year (Abstract GS1-01 ).
A silicone-based polyurethane film dressing (known as Mepitel® Film) appears to be beneficial in reducing skin toxicities caused by radiation treatment, according to data presented during the October 2022 ASCO Plenary Series.1 The results of a phase III trial showed that this film dressing may be...
Compared with capecitabine-based regimens, fam-trastuzumab deruxtecan-nxki (T-DXd) led to higher response rates and longer survival in the third-line setting for patients with HER2-positive metastatic breast cancer previously treated with ado-trastuzumab emtansine (T-DM1), according to results from ...
Patients with localized, hormone receptor (HR)-positive, HER2-low breast cancer treated with fam-trastuzumab deruxtecan-nxki (T-DXd) in the neoadjuvant setting had an overall response rate of 75% without combining the agent with anastrozole and 63% in combination with anastrozole, according to...
In patients with hormone receptor–positive, HER2-negative advanced breast cancer—including patients with visceral crises—those treated with ribociclib plus endocrine therapy had fewer adverse events and significantly longer progression-free survival compared to those treated with combination...
The incidence of anaplastic large cell lymphoma (ALCL) has surged in recent years—possibly because of the growing use of textured breast implants. Considering this trend, some patients with breast cancer who undergo mastectomy may wonder if the benefits of getting reconstructive implants are worth...
Residual tumors from Black patients with estrogen receptor–positive/HER2-negative primary breast cancer treated with neoadjuvant chemotherapy had a higher risk score associated with a biomarker of distant metastatic recurrence compared with tumors from White patients, according to new findings...
Among premenopausal patients with hormone receptor–positive, early-stage breast cancer enrolled in the SOFT trial, those with a high score on the Breast Cancer Index genomic assay had an increased risk of distant recurrence—and those with a low score on the Breast Cancer Index may have benefited...
Non-Hispanic Black patients with lymph node–positive, hormone receptor (HR)–positive/HER2-negative breast cancer experienced worse outcomes compared with the outcomes of non-Hispanic White, Asian, and Hispanic patients—despite similar 21-gene recurrence scores—according to new findings presented by ...
In a cohort study reported in JAMA Network Open, Chen et al found that postmenopausal breast cancer survivors with exercise patterns categorized as active or moderately active had significantly reduced risk for all-cause mortality compared to those with patterns categorized as insufficiently...
In a U.S. cross-sectional study reported in JAMA Oncology, Oakes et al found that as of December 2021, breast, cervical, and colorectal cancer screening rates remained below pre–COVID-19 pandemic levels, despite initial rebounds in some rates. Reduced screening rates were accompanied by reduced...
Twenty percent of patients are likely to forgo additional testing after an abnormal finding on a screening mammogram if there is a deductible, according to new findings presented at the Radiological Society of North America (RSNA) 2022 Annual Meeting. Background As health-care costs and insurance...
Patients with HER2-positive breast cancer may be less likely to survive if their initial treatment fails to eradicate the tumor completely and they have high levels of tumor-infiltrating lymphocytes in their residual tumors, according to a new study published by Miglietta et al in the European...
Using intraoperative ultrasound to guide surgery for patients with ductal carcinoma in situ may yield better results than the standard technique of using a wire inserted into the breast, according to a new study published by Esgueva et al in the European Journal of Cancer. The findings were also...
As reported in the Journal of Clinical Oncology by Bartels et al, 10-year outcomes from the phase III EORTC 10981-22023 AMAROS trial were similar with axillary lymph node dissection (ALND) vs axillary radiotherapy in patients with cT1–2, node-negative breast cancer and a positive sentinel node...
Lori Wilson, MD, FACS, was the first woman to hold the surgical oncology division chief position at Howard University Hospital and the first woman to be promoted to full professor in surgery at Howard University College of Medicine. Known as a fierce advocate for patients with cancer in underserved ...
Julia Tchou, MD, PhD, of the University of Pennsylvania, discusses preliminary results of the phase Ib/II BreastVax study, which suggested a single preoperative pembrolizumab dose plus a tumor-targeting radiation boost may result in pathologic response in patients with early-stage triple-negative breast cancer (Abstract 644).
Researchers have discovered that patients with type 2 diabetes who develop cancer are more likely to be diagnosed with advanced disease if they do not undergo routine screenings, according to a new study published by Jansana et al in the European Journal of Cancer. The new findings were also...
On August 5, 2022, fam-trastuzumab deruxte-can-nxki was approved for patients with unresectable or metastatic HER2-low (immunohistochemistry [IHC] 1+ or IHC 2+/in situ hybridization–negative) breast cancer who have received prior chemotherapy in the metastatic setting or developed disease...
Researchers have created a model for predicting an individual’s breast cancer risk that could be used to create personalized breast cancer screening strategies, according to a new study published by Louro et al in the European Journal of Cancer. The research, also presented at the 13th European...
In a preplanned analysis of the stage IIA cohort of the PALLAS trial, the addition of adjuvant palbociclib to standard endocrine therapy did not improve outcomes over endocrine therapy alone. This finding suggests this agent provides no benefit in reducing the risk of early relapse in patients with ...