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Breast Cancer

To Elect or Forgo Radiation Therapy: An Informed Decision for Patients With Breast Cancer

Advances in treating breast cancer “increasingly create opportunities to consider where radiation therapy might safely be omitted,” Reshma Jagsi, MD, DPhil, told participants at the 2021 Lynn Sage Breast Cancer Symposium.1 “But, I would encourage us,” she continued, “not to assume that women who...

breast cancer
immunotherapy

Hans Wildiers, MD, on Metastatic Breast Cancer: Comparing Addition of Eftilagimod Alpha vs Placebo to Paclitaxel

Hans Wildiers, MD, of University Hospitals Leuven, discusses the final results from the phase IIb AIPAC study, which suggested that eftilagimod added to paclitaxel may be of benefit to patients older than 65 years with hormone receptor­–positive, HER2-negative metastatic breast cancer after endocrine-based therapy. Eftilagimod, which is a first-in-class antigen presenting cell activator, appeared to increase circulating CD4/CD8 T cells, which correlated to improved overall survival (Abstract 948).

Breast Cancer

Study Examines the Effect of Breast MRI on Short-Term Quality of Life in Women With DCIS

In a substudy of the ECOG-ACRIN E4112 cohort trial reported in JAMA Network Open, Fazeli et al found that approximately half of women with ductal carcinoma in situ (DCIS) undergoing magnetic resonance imaging (MRI) for pretreatment planning experienced fear or anxiety before and during the...

Breast Cancer
Immunotherapy

Eftilagimod Alpha Plus Paclitaxel May Improve Survival in HR-Positive, HER2-Negative Metastatic Breast Cancer: AIPAC Trial

The addition of the LAG-3 protein eftilagimod alpha to paclitaxel led to a significant improvement in overall survival in younger patients with hormone receptor (HR)-positive, HER2-negative metastatic breast cancer, according to data presented by Hans Wildiers, MD, and colleagues at the Society for ...

Breast Cancer

Aditya Bardia, MD, MPH, Comments on Findings From monarchE

The invited discussant of monarchE,1 Aditya Bardia, MD, MPH, Director, Breast Cancer Research, and Associate Professor of Medicine, Harvard Medical School, commented: “Based on a hazard ratio of 0.69 for invasive disease–free survival, the results are statistically significant and clinically...

Breast Cancer

Long-Term Follow-up of monarchE: Benefit of Abemaciclib Plus Endocrine Therapy Maintained in Early High-Risk Breast Cancer

Longer-term follow-up of the global phase III monarchE trial showed an increasing benefit for adding abemaciclib to endocrine therapy in the adjuvant treatment of early high-risk hormone receptor–positive, HER2-negative breast cancer, regardless of Ki67 index. The latest findings were reported at a ...

Breast Cancer

Phase II Breast Cancer Trial: Large Declines in Ki67 Index Seen With Oral Selective Estrogen Receptor Degrader

In the phase II coopERA Breast Cancer trial, which evaluated two endocrine neoadjuvant therapies in estrogen receptor–positive, HER2-negative early breast cancer, the oral selective estrogen receptor degrader giredestrant led to a greater reduction in Ki67 level—a measure of cancer cell...

Breast Cancer

Duration of Endocrine Therapy in Breast Cancer: How Much of a Good Thing Is Too Much?

Estrogen receptor–positive breast cancer is the most common type of breast cancer, diagnosed in more than 2.3 million women around the world each year, including more than 200,000 in the United States alone. Adjuvant endocrine therapy is a mainstay of treatment for these millions of women and is a...

Breast Cancer

No Disease-Free Survival Difference With Longer Anastrozole Treatment After Endocrine Therapy in HR-Positive Breast Cancer

In an Austrian Breast and Colorectal Cancer Study Group phase III trial (ABCSG-16/SALSA) reported in The New England Journal of Medicine, Michael Gnant, MD, of the Comprehensive Cancer Center, Medical University of Vienna, and colleagues found no difference in disease-free survival with 2 vs 5...

Lung Cancer
Breast Cancer

Can SBRT to Selected Sites of Limited Progression or Oligoprogression Extend Progression-Free Survival in Advanced Lung Cancer but Not Breast Cancer?

Stereotactic body radiation therapy (SBRT) lengthens progression-free survival for patients with advanced lung cancer who have oligoprogression (ie, tumors that have not been fully responsive to systemic chemotherapy or immunotherapy), according to an interim analysis of the CURB oligoprogression...

Breast Cancer

Accelerated Radiation Therapies Move Forward in Early Breast Cancer

Two studies reported at the 2021 American Society for Radiation Oncology (ASTRO) Annual Meeting provide evidence in support of the use of accelerated radiation therapies as safe alternatives to standard radiotherapy options following breast-conserving surgery. The phase III MC1635 trial showed...

Breast Cancer

AI-Based Breast Cancer Risk Model: Multi-institution Validation

In a study reported in the Journal of Clinical Oncology, Yala et al found that using the artificial intelligence (AI)-based Mirai model across diverse populations resulted in consistently accurate predictions of breast cancer risk based on screening mammography. Study Details In the study, Mirai...

Breast Cancer

Exercise Program May Help to Reduce Upper Limb Disability After Breast Cancer Surgery

Arm and shoulder disability and pain that some women who have had breast cancer surgery experience as a side effect of their procedure may be reduced by following a physiotherapy-led exercise program, according to a new study published by Bruce et al in The BMJ. The report showed an improvement in...

breast cancer

Yongbae Kim, MD, on Elective Internal Mammary Node Irradiation in Women With Node-Positive Breast Cancer: Results of a Randomized Phase III Trial

Yongbae Kim, MD, of the Yonsei Cancer Center and Yonsei University College of Medicine, discusses findings that showed the use of internal mammary area irradiation (IMNI) in regional nodal irradiation did not significantly improve disease-free survival for women with node-positive breast cancer. However, patients with medially or centrally located tumors may be considered for treatment with IMNI (Abstract 2).

Breast Cancer

Expert Point of View: Monica Arnedos, MD, PhD

The invited discussant of BrighTNess,1 Monica Arnedos, MD, PhD, Head of the Breast Cancer Research Program at the Institut Bergonié in Bordeaux, France, said the findings add to growing support for using carboplatin in triple-negative breast cancer, but their clinical application could be...

Breast Cancer

BrighTNess: Neoadjuvant Carboplatin Improves Event-Free Survival in Triple-Negative Breast Cancer

In patients with early resectable triple-negative breast cancer, not only did the addition of carboplatin to standard neoadjuvant chemotherapy improve pathologic complete response rates, it also improved 4-year event-free survival, regardless of BRCA status, according to the latest analysis of the...

Breast Cancer

CDK4/6 Inhibitors Combined With Fulvestrant for Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer: FDA Analysis of Overall Survival

In an exploratory U.S. Food and Drug Administration (FDA) pooled analysis reported in The Lancet Oncology, Jennifer J. Gao, MD, and colleagues found that the addition of CDK4/6 inhibitor treatment to fulvestrant resulted in a consistent overall survival benefit vs placebo plus fulvestrant in...

Breast Cancer

Fear of Side Effects and Lack of Awareness: Barriers to Greater Use of Risk-Reducing Medications for Breast Cancer

A “big problem, maybe the major one,” with risk-reducing medications for breast cancer is low uptake among women at high risk of breast cancer,” Seema A. Khan, MD, told participants at the 2021 Annual Lynn Sage Breast Cancer Symposium.1 Dr. Khan is Professor of Surgery and the Bluhm Family...

Breast Cancer

Risk-Reducing Medications for Breast Cancer Are Becoming Safer and More Tolerable

Risk-reducing medications for breast cancer may be effective for many women, and recently reported and ongoing trials have led to improvements in their tolerability and safety, Seema A. Khan, MD, reported at the 2021 Annual Lynn Sage Breast Cancer Symposium (virtual).1 Dr. Khan is Professor of...

Breast Cancer

Optimizing Adjuvant Therapy for Women With Estrogen Receptor–Positive, Node-Positive Breast Cancer

“Nodal status remains the single most important prognostic marker in outcomes for women with estrogen receptor–positive, HER2-negative breast cancer. For that reason, it makes sense to think about optimizing adjuvant therapy, including endocrine treatments, chemotherapy, and targeted therapy,”...

Breast Cancer

Adjuvant Internal Mammary Node Irradiation in Node-Positive Breast Cancer

In a Korean phase III trial reported in JAMA Oncology, Kim et al found that the addition of internal mammary node irradiation to adjuvant regional nodal irradiation did not improve 7-year disease-free survival in women with node-positive breast cancer. In an ad hoc analysis, however, benefit was...

Breast Cancer
Genomics/Genetics

Germline Pathogenic Variants in Cancer Predisposition Genes and Risk for Invasive Lobular Carcinoma of the Breast

In a study reported in the Journal of Clinical Oncology, Yadav et al found that germline pathogenic variants in the cancer predisposition genes ATM, BRCA2, CDH1, CHEK2, and PALB2 were associated with an increased risk of invasive lobular carcinoma of the breast, with no association with BRCA1...

Breast Cancer

Retrospective Study Examines Real-World Survival in U.S. Women Treated for Early-Stage Breast Cancer

In a retrospective cohort study reported in JCO Oncology Practice, Gidwani et al found that among U.S. patients treated for early-stage breast cancer, those who were considered to be unrepresented in clinical trials have significantly poorer survival than those categorized as well represented....

breast cancer
lung cancer
issues in oncology

Matthew Manning, MD, on Resolving Racial Disparities in the Treatment of Breast and Lung Cancers

Matthew Manning, MD, of Cone Health Cancer Center, discusses findings that showed changes to the way cancer care is delivered may help eliminate racial disparities in survival among patients with early-stage lung and breast cancers. Identifying and addressing obstacles that kept patients from finishing radiation treatments for cancer were associated with improved 5-year survival rates for all patients (Abstract 53).

breast cancer
lung cancer

C. Jillian Tsai, MD, PhD, on Using Radiotherapy to Thwart Tumor Growth in Advanced Cancers

C. Jillian Tsai, MD, PhD, of Memorial Sloan Kettering Cancer Center, discusses results from the first randomized trial of stereotactic body radiation therapy (SBRT) to treat oligoprogressive, metastatic lung and breast cancers. The standard of care for patients with these types of tumors is to switch to a different systemic treatment. Adding local therapy such as SBRT may help treat drug-resistant lesions (Abstract LBA3).  

Breast Cancer
Gastrointestinal Cancer
Genomics/Genetics

Rates of Occult Gastric Carcinoma in Patients With Hereditary Lobular Breast Cancer Due to CDH1 Genetic Variants

In a single-institution prospective cohort study reported in JAMA Surgery, Gamble et al found that patients with hereditary lobular breast cancer due to CDH1 variants also had a high prevalence of occult signet ring cell gastric carcinoma. Study Details The study involved 283 patients from 151...

Breast Cancer
Genomics/Genetics
Issues in Oncology

Survey of U.S. Oncologists on Genetic Counseling and Testing for Black Women With Breast Cancer

As reported in the Journal of Clinical Oncology by Ademuyiwa et al, a survey of U.S. breast oncologists showed that physicians believe that Black women with breast cancer face more barriers to genetic counseling and testing compared to White women with breast cancer. Study Details The study...

breast cancer
immunotherapy
symptom management

Youssef Zeidan, MD, PhD, on HER2-Positive Breast Cancer: Treatment-Related Cardiotoxicity

Youssef Zeidan, MD, PhD, of Florida International University and the Lynn Cancer Institute, discusses the advances in radiotherapy planning and delivery that have reduced cardiac radiation exposure in patients with HER2-positive breast cancer who are treated with radiotherapy and trastuzumab (Abstract 12).

Breast Cancer
Lung Cancer
Issues in Oncology

ACCURE Trial Aims to Eliminate Disparities in Survival in Black and White Patients With Early-Stage Lung and Breast Cancers

A study presented by Manning et al at the 2021 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 53) showed that interventions to help Black patients overcome obstacles to completion of treatment can impact disparities in survival outcomes between Black and White patients...

Breast Cancer
Global Cancer Care

Urbanization in Bangladesh: The Prevalence of Breast Cancer Brings Unique Challenges

The number of deaths related to breast cancer are increasing at an alarming pace worldwide. According to a World Health Organization (WHO) 2020 report, approximately 2,088,849 new cases and 627,000 deaths related to breast cancer occurred in 2018.1 More than 55% of these deaths occurred in low- to ...

breast cancer

Katherine E. Reeder-Hayes, MD, MBA, on Geography, Breast Cancer Treatment, and Racial Disparities

Katherine E. Reeder-Hayes, MD, MBA, of the University of North Carolina at Chapel Hill, discusses the timeliness of breast cancer care for Black women compared with non-Black women in North Carolina. Her data showed that greater geographic variation exists in the timeliness of breast cancer care for Black women, with regions surrounding larger urban centers having the largest disparities.

breast cancer
immunotherapy

Hope S. Rugo, MD, on Triple-Negative Breast Cancer: Treatment Findings From KEYNOTE-355 on Pembrolizumab and Chemotherapy

Hope S. Rugo, MD, of the University of California, San Francisco, discusses phase III results from the KEYNOTE-355 study of pembrolizumab plus chemotherapy, which improved overall survival vs chemotherapy alone in patients with previously untreated locally recurrent, inoperable, or metastatic triple-negative breast cancer whose tumors expressed PD-L1 (Abstract LBA16).

Breast Cancer
Immunotherapy

Another Antibody-Drug Conjugate Enters the Metastatic Breast Cancer Landscape

In the global phase III TULIP trial in metastatic HER2-positive breast cancer, treatment with the antibody-drug conjugate vic-trastuzumab duocarmazine (SYD985) significantly improved progression-free survival in comparison with standard chemotherapy in previously treated patients, making this a new ...

Breast Cancer

MONALEESA-2: Overall Survival Benefit With First-Line Ribociclib Plus Letrozole

Ribociclib plus hormonal therapy in the first-line setting boosted overall survival by more than 1 year, vs hormone therapy alone, in postmenopausal women with hormone receptor–positive HER2-negative advanced breast cancer, according to the latest findings from the MONALEESA-2 trial, reported at...

Breast Cancer

Development of a Breast Cancer Risk Prediction Model for Black Women in the United States

As reported in the Journal of Clinical Oncology, Julie R. Palmer, ScD, and colleagues have developed and validated a risk prediction model for invasive breast cancer in Black women in the United States. Study Details For the development of the model, breast cancer relative and attributable risks...

Breast Cancer

Preclinical Study Examines Relationship Between Aging Breast Tissue and Invasive Breast Cancer

Breast cancer risk increases with age, but while scientists have long studied cellular changes that take place in the body over time, a new study published by Bahcecioglu et al in Advanced Science examined how the extracellular matrix—an underlying network of molecules and proteins that provide the ...

Breast Cancer

First-Line Fulvestrant/Palbociclib vs Letrozole/Palbociclib for Endocrine-Sensitive, HR-Positive, HER2-Negative Advanced Breast Cancer

In the phase II PARSIFAL trial reported in JAMA Oncology, Antonio Llombart-Cussac, MD, and colleagues found that the combination of fulvestrant plus palbociclib did not improve progression-free survival vs letrozole plus palbociclib in women with advanced endocrine-sensitive, hormone receptor...

Breast Cancer
Global Cancer Care

Global Analysis of National Health System Characteristics and Breast Cancer Mortality and Stage at Diagnosis

In a global population-based study reported in The Lancet Oncology, Duggan et al identified national health system characteristics associated with reduced breast cancer mortality, including higher Universal Health Coverage Service Coverage Index (UHC Index) rating and increased number of public...

Breast Cancer

Nodal Recurrence With Sentinel Node Biopsy Alone Following Neoadjuvant Chemotherapy for Node-Positive Breast Cancer

In a single-center cohort study reported in JAMA Oncology, Barrio et al evaluated nodal recurrence rates in patients with clinically node-negative breast cancer following neoadjuvant chemotherapy for biopsy-proven node-positive disease. The investigators found an extremely low incidence of nodal...

Breast Cancer

Is Baseline Brain White Matter Microstructure Associated With Cognitive Decline After Chemotherapy for Breast Cancer?

In a Dutch study reported in the Journal of Clinical Oncology, de Ruiter et al found that white matter microstructure at baseline was associated with cognitive decline after chemotherapy for breast cancer. Study Details The study included 49 patients with breast cancer who received...

Breast Cancer

FDA Approves Abemaciclib in Combination With Endocrine Therapy for Early Breast Cancer

On October 12, the U.S. Food and Drug Administration (FDA) approved abemaciclib (Verzenio) in combination with endocrine therapy (tamoxifen or an aromatase inhibitor) for the adjuvant treatment of adult patients with hormone receptor (HR)-positive, HER2-negative, node-positive early breast cancer...

Breast Cancer

Recent FDA Approvals in Breast Cancer

In the past year, the U.S. Food and Drug Administration (FDA) approved five treatment options for patients with breast cancer, which are summarized herein. Abemaciclib Combination On October 12, 2021, the FDA approved abemaciclib (Verzenio) with endocrine therapy (tamoxifen or an aromatase...

Breast Cancer

KEYNOTE-355: Pembrolizumab Plus Chemotherapy Improves Progression-Free Survival in PD-L1–Enriched Advanced Triple-Negative Breast Cancer

Pembrolizumab plus chemotherapy improved progression-free survival vs chemotherapy alone as first-line treatment of advanced or metastatic triple-negative breast cancer, according to the results of KEYNOTE-355.1 Progression-free survival was significantly improved with pembrolizumab plus...

Breast Cancer

EA1131 Trial: Platinum Not Equal to Capecitabine for Residual Disease in Triple-Negative Breast Cancer

In patients with triple-negative breast cancer who have residual disease after neoadjuvant chemotherapy, adjuvant capecitabine remains the standard of care. In the multicenter randomized noninferiority EA1131 trial, which included primarily basal tumors, noninferiority of adjuvant platinum over...

Breast Cancer

Sacituzumab Govitecan-hziy Improves Survival vs Single-Agent Chemotherapy in Metastatic Triple-Negative Breast Cancer

As reported in The New England Journal of Medicine by Aditya Bardia, MD, of the Division of Medical Oncology, Massachusetts General Hospital Cancer Center, and colleagues, the phase III ASCENT trial has shown prolonged progression-free and overall survival with the Trop-2–directed antibody-drug...

Breast Cancer

Neoadjuvant Durvalumab Improves Long-Term Outcomes in the GeparNuevo Trial

In the phase II GeparNuevo trial, patients with early triple-negative breast cancer receiving the PD-L1 inhibitor durvalumab in addition to chemotherapy as neoadjuvant therapy saw improvements in long-term outcomes. The results were presented at the 2021 ASCO Annual Meeting by Sibylle Loibl, MD,...

Breast Cancer

KEYNOTE-522: Neoadjuvant Pembrolizumab Improves Event-Free Survival in Triple-Negative Breast Cancer

The latest analysis of the phase III KEYNOTE-522 trial demonstrated significant improvements in clinical outcomes with pembrolizumab plus chemotherapy vs chemotherapy alone as a neoadjuvant/adjuvant treatment of triple-negative breast cancer.1 This is the first large, randomized, phase III trial to ...

Breast Cancer

Early Triple-Negative Breast Cancer: Are Checkpoint Inhibitors Ready for Neoadjuvant or Adjuvant Use?

Recent clinical trials have been encouraging for the neoadjuvant or adjuvant use of immune checkpoint inhibitors in triple-negative breast cancer, but is this approach ready for the clinic? This question was addressed at the 38th Miami Breast Cancer Conference, held virtually this year, by Adam M....

Breast Cancer

Margetuximab-cmkb Plus Chemotherapy Prolongs Progression-Free Survival in Heavily Pretreated HER2 Positive Breast Cancer

As reported in JAMA Oncology by Hope S. Rugo, MD, of the University of California San Francisco Helen Diller Family Comprehensive Cancer Center, and colleagues, the phase III SOPHIA trial has shown significantly prolonged progression-free survival with margetuximab-cmkb plus chemotherapy vs...

Breast Cancer

ADAPT Trial: ‘Excellent’ Outcomes Reported With Neoadjuvant Dual HER2 Therapy in Breast Cancer

The first overall survival analysis of the WGS-ADAPT HER2+/HR– study, which evaluated neoadjuvant therapy in patients with hormone receptor–negative, HER2-positive disease, showed that treatment with pertuzumab and trastuzumab plus paclitaxel—or with the chemotherapy-free regimen of...

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