Patients With Breast Cancer Provide Recommendations to Ease Financial Toxicity
A qualitative study yielded nine patient-driven recommendations across circumstances that include changes to insurance, supportive services, and financial assistance to reduce long-term, breast cancer–related economic burden. The study was published by Dean et al in Cancer. Unique...
FDA Pipeline: Updates on Treatments for Cervical Cancer, Myelofibrosis, Chemotherapy-Induced Nausea and Vomiting, and More
The FDA recently issued announcements on a Fast Track designation, a Priority Review, two supplemental new drug applications, an investigational new drug application, and a marketing clearance. The agency also released a safety communication on cancer-related surgery. Fast Track Designation for...
G. Travis Clifton, MD, on Breast Cancer and Disease Recurrence: Final Analysis From a Study of Nelipepimut-S, GM-CSF, and Trastuzumab
G. Travis Clifton, MD, of Brooke Army Medical Center, discusses phase IIb trial findings on nelipepimut-S plus GM-CSF with trastuzumab vs trastuzumab alone to prevent recurrences of high-risk, HER2 low-expressing breast cancer (Abstract 1).
Elizabeth A. Mittendorf, MD, PhD, on Breast Cancer Immunotherapy: Building on Recent Successes
Elizabeth A. Mittendorf, MD, PhD, of Dana-Farber Cancer Institute, discusses the encouraging data on atezolizumab plus nab-paclitaxel in the first-line setting for metastatic triple-negative breast cancer, and the potential benefits of combining immune checkpoint inhibitors with targeted treatment in breast cancer.
Neoadjuvant Palbociclib Plus Letrozole Reduces Ki67 Levels
In the neoadjuvant setting, adding palbociclib to letrozole significantly enhanced the suppression of malignant cell proliferation, as measured by Ki67 levels, in patients with primary estrogen receptor–positive breast cancer but did not increase the clinical response rate over 14 weeks, according ...
Long-Term Study Finds Axillary Radiotherapy Safe and Effective After Positive Sentinel Node Biopsy
Following identification of a positive sentinel lymph node, surgical axillary lymph node dissection and axillary radiation therapy provide comparable locoregional control and survival, according to a 10-year follow-up of the large European Organisation for Research and Treatment of Cancer AMAROS...
Biologic Age and Elevated Breast Cancer Risk
Biologic age—a DNA-based estimate of a person’s age—may be associated with development of breast cancer, according a report published by Kresovich et al in the Journal of the National Cancer Institute. Study Methods Scientists from the National Institute of Environmental Health...
More Data Show Small Benefit From Extended Endocrine Therapy
Two studies presented at the 2018 San Antonio Breast Cancer Symposium validated a small benefit of extending adjuvant aromatase inhibitor therapy beyond thestandard 5 years for postmenopausal women with hormone receptor–positive breast cancer. In a meta-analysis of 24,912 patients from 12...
Does Adjuvant Denosumab Improve DFS in Postmenopausal Women With Hormone Receptor–Positive Breast Cancer Receiving Aromatase Inhibitors?
As reported by Gnant et al in The Lancet Oncology, disease-free survival (DFS) was improved with adjuvant denosumab vs placebo in postmenopausal women with hormone receptor–positive, early-stage breast cancer receiving aromatase inhibitor treatment. A primary analysis of the phase III...
Can Cognitive Behavioral Therapy Improve Treatment-Induced Menopausal Symptoms in Survivors of Breast Cancer?
In a Dutch study reported in the Journal of Clinical Oncology, Atema et al found that an Internet-based cognitive behavioral therapy (iCBT) intervention improved treatment-induced menopausal symptoms in breast cancer survivors compared with a waiting list control group. In the study, 254 women...
2019 ASCO-SITC: Combination Immunotherapy for Breast Cancer With Trastuzumab and a HER2-Targeted Vaccine
After preclinical findings showed shared activity between trastuzumab and HER2-targeted vaccines, researchers evaluated adjvuant nelipepimut-S plus granulocyte-macrophage colony-stimulating factor (GM-CSF) with trastuzumab compared to trastuzumab with GM-CSF alone in patients with HER2...
FDA Approves Trastuzumab and Hyaluronidase-oysk for Subcutaneous Injection in Certain HER2-Positive Breast Cancers
On February 28, the U.S. Food and Drug Administration (FDA) approved trastuzumab and hyaluronidase-oysk (Herceptin Hylecta) for subcutaneous injection for the treatment of certain patients with HER2-positive early breast cancer (node-positive, or node-negative and estrogen receptor/progesterone...
Sacituzumab Govitecan-hziy in Heavily Pretreated, Metastatic Triple-Negative Breast Cancer
In a phase I/II trial reported in The New England Journal of Medicine, Bardia et al found durable responses with the antibody-drug conjugate sacituzumab govitecan-hziy in patients with heavily pretreated, metastatic triple-negative breast cancer. The monoclonal antibody sacituzumab targets the...
Addition of Pembrolizumab to Trastuzumab in PD-L1–Positive, Trastuzumab-Resistant, HER2-Positive Breast Cancer
In the phase II portion of a phase Ib/II trial reported in The Lancet Oncology, Loi et al found evidence of activity of pembrolizumab plus trastuzumab in programmed cell death protein ligand 1 (PD-L1)-positive, trastuzumab-resistant, HER2-positive advanced breast cancer. Study Details In the...
Expert Point of View: Carlos L. Arteaga, MD
CARLOS L. ARTEAGA, MD, Director of the Harold C. Simmons Comprehensive Cancer Center and Associate Dean of Oncology Programs at The University of Texas Southwestern Medical Center, Dallas, expressed some caution about the overall applicability of the findings of the PADDY trial. Primarily, he...
Prognostic Value of Disseminated Tumor Cells in Early Breast Cancer
IN THE PADDY TRIAL, involving more than 10,000 women with early invasive breast cancer, the presence of disseminated tumor cells at diagnosis or primary surgery was an independent prognostic factor for overall, disease-free, and distant disease–free survival. The study findings were presented at...
SABCS Presentations Offer New Data on Biomarkers and Novel Treatment Approaches in Early and Metastatic Breast Cancers
REPORTERS FOR The ASCO Post captured the following summaries of noteworthy studies presented at the 2018 San Antonio Breast Cancer Symposium. In HER2-Negative Metastatic Disease, CTCs Frequently HER2-Positive ALMOST HALF of all patients with HER2-negative metastatic breast cancer have circulating...
Adherence to Endocrine Therapy for Breast Cancer in Black Women and White Women
In a study reported in the Journal of the National Cancer Institute, Stephanie B. Wheeler, MPH, PhD, of the Department of Health Policy and Management, University of North Carolina, Chapel Hill, and colleagues found that black women reported nonadherence to endocrine therapy for breast cancer more ...
Estradiol as Potential Treatment for Subset of Triple-Negative Breast Cancers
Mayo Clinic researchers have identified estradiol as a potential new treatment for a subset of women with triple-negative breast cancer. Their findings were published by Reese et al in the Proceedings of the National Academy of Sciences of the United States of America. “Triple-negative breast...
Increased Risk of Bone Loss Extends to Younger Women Treated for Breast Cancer
Younger women who have been treated for breast cancer have a higher risk for osteopenia and osteoporosis than do their cancer-free peers, and that risk seems to rise when treatment involves chemotherapy plus hormone therapy or aromatase inhibitors alone. Researchers from Johns Hopkins Bloomberg...
Benefit of Annual Screening in Women Aged 35–39 With a Family History of Breast Cancer
Annual screening for women aged 35–39 who have a family history of breast cancer may be highly effective in detecting tumors earlier, according to findings published by Evans et al in The Lancet’s online journal EClinicalMedicine. The FH02 trial found that annual mammograms for...
Meta-analysis of Outcomes With Dose-Intense Adjuvant Chemotherapy in Early Breast Cancer
In a patient-level meta-analysis reported in The Lancet, the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) found that an increased dose intensity of adjuvant taxane and anthracycline chemotherapy in early breast cancer was associated with a decreased risk of recurrence and death ...
New Approach to Predicting Response to Pertuzumab and Trastuzumab in Breast Cancer
In the phase II TBCRC026 study reported in the Journal of Clinical Oncology, Connolly et al found that early changes in tumor maximum standardized uptake values corrected for lean body mass (SULmax) on [18F]fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) were...
Recent Decrease in Deaths Attributable to Breast Cancer in the United States
The latest U.S. estimates indicate that since 1989, hundreds of thousands of women's lives have been saved by mammography and improvements in breast cancer treatment. In a study published by Hendrick et al in Cancer, findings point to progress made in the early detection and management of...
MRI and Assay Results May Influence Treatment of DCIS
In a prospective cohort clinical trial reported in JAMA Oncology, Lehman et al found that multiple factors, including magnetic resonance imaging (MRI) findings, played a role in conversion to mastectomy among women with ductal carcinoma in situ (DCIS) who were candidates for wide local excision...
Breast Cancer Surgical Terminology Should Be Updated to Reflect Modern Medical Practice
BREAST CANCER is a microscopic disease, with most patients presenting with “localized” stage I to III disease, for which they are offered curative-intent surgery often accompanied by radiation therapy, chemotherapy, and hormonal therapy. More accurately, we now know that patients with localized...
Postmastectomy Hypofractionated vs Conventionally Fractionated Radiotherapy for High-Risk Breast Cancer
In a Chinese, single-center, noninferiority phase III trial reported in The Lancet Oncology, Wang et al found that postmastectomy hypofractionated radiotherapy was noninferior to and associated with similar toxicities vs conventionally fractionated radiotherapy in patients with high-risk breast...
CYP2D6 Genotypes, Endoxifen Levels, and Clinical Outcome in Early-Stage Breast Cancer Treated With Adjuvant Tamoxifen
In a Dutch-Belgian study (CYPTAM) reported in the Journal of Clinical Oncology, Sanchez-Spitman et al found no associations between CYP2D6 genotypes or levels of endoxifen (active metabolite of tamoxifen) and clinical outcomes in patients receiving adjuvant tamoxifen for early-stage breast cancer....
Effect of Peer Review Within a Cancer Care Network on Use of Hypofractionated Radiotherapy for Early-Stage Breast Cancer
In a study reported in the Journal of Oncology Practice, Ganju et al found that implementation of a cancer care network–wide peer review process aimed at standardizing treatment resulted in increasing use of hypofractionated radiotherapy in early-stage breast cancer at community-based...
Small Differences Found in Breast Cancer Recurrence With Partial-Breast vs Whole-Breast Irradiation
Partial-breast irradiation delivered over 5 to 10 days did not meet noninferiority criteria compared with whole-breast irradiation given over 5 to 7 weeks, according to 10-year results of the large NRG (NSABP B-39/RTOG 0413) trial presented at the 2018 San Antonio Breast Cancer Symposium.1 However, ...
Selected Abstracts From the San Antonio Breast Cancer Symposium
Each year, The ASCO Post asks Jame Abraham, MD, FACP, Director of the Breast Oncology Program at Taussig Cancer Institute and Professor of Medicine at the Cleveland Clinic Lerner College of Medicine, to offer his picks for the most important research presented at the 2018 San Antonio Breast Cancer ...
Racial Differences in Time to Breast Cancer Surgery and Survival in the U.S. Military Health System
In a retrospective cohort study reported in JAMA Surgery, Eaglehouse et al found that time to breast cancer surgery was delayed for non-Hispanic black vs non-Hispanic white women in the Military Health System but that this difference did not account for poorer overall survival in non-Hispanic black ...
Cost-Effectiveness Analysis of Gene-Expression Profiling Assay in Breast Cancer
A new report published by Wang et al in JNCCN—Journal of the National Comprehensive Cancer Network found that using Oncotype DX—the most commonly used test for predicting the benefit of adjuvant chemotherapy to reduce the risk of disease recurrence—is not...
Short-Term Safety Outcomes in Mastectomy and Immediate Implant-Based Breast Reconstruction
In a prospective cohort study reported in The Lancet Oncology, Potter et al found that complications following immediate implant-based breast reconstruction—with or without mesh—were higher than considered acceptable by UK national standards. As noted by the investigators, the study was ...
Genomic Classifier for Luminal Androgen Receptor Triple-Negative Breast Cancer
TRIPLE-NEGATIVE breast cancer is a heterogeneous disease that comprises several subtypes, which may respond differently to therapy. Breast cancer researchers at the Mayo Clinic are developing a novel genomic signature that may improve the identification of the luminal androgen receptor vs basal...
IMpassion130 Trial: Changing the Treatment Landscape in Metastatic Triple-Negative Breast Cancer
THE IMPASSION130 trial—reported in The New England Journal of Medicine by Schmid et al1 and reviewed in this issue of The ASCO Post—was an eagerly awaited study in newly diagnosed metastatic triple-negative breast cancer. To briefly review, 902 patients were randomly assigned in a 1:1 fashion to...
Addition of Atezolizumab to Nab-Paclitaxel in Advanced Triple-Negative Breast Cancer: IMpassion130 Trial
AS REPORTED in The New England Journal of Medicine by Peter Schmid, MD, PhD, of the Barts Cancer Institute, Queen Mary University of London, and colleagues, the phase III IMpassion130 trial has shown that the addition of atezolizumab to nanoparticle albumin-bound (nab)-paclitaxel significantly...
Challenge Moving Forward in Breast Cancer Treatment: To Show That New Approaches Change Outcomes
ADVANCES IN treating breast cancer over the past 20 years have brought us to the point where treatment can be confidently de-escalated for some patients, and immunotherapy and precision decision-making may change the way breast cancer is treated for others, William Gradishar MD, FASCO, told the...
Preventing Locoregional Recurrence of Breast Cancer Should Not Deter Efforts to Decelerate Therapy
“SURGEONS AND radiation oncologists are obsessed with locoregional recurrence of breast cancer,” Monica Morrow, MD, FASCO, remarked at the 2018 Lynn Sage Breast Cancer Symposium, Chicago. Working to prevent locoregional recurrence, “even if it may not be the major threat to mortality, is...
Risk of Local Recurrence in Breast Cancer: Impact of Molecular Subtype and Surgical Approach
THE RISK of local recurrence in breast cancer “does not differ substantially based on the operation we perform, but it does differ substantially by subtype,” Tari A. King MD, FACS, stated at the 2018 Lynn Sage Breast Cancer Symposium in Chicago.1 At 10-year follow-up, Dr. King reported, local...
Expert Point of View: C. Kent Osborne, MD
COMMENTING ON the ACCRU study SC-1603, press conference moderator C. Kent Osborne, MD, Director of the Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine in Houston and Co-Director of the San Antonio Breast Cancer Symposium, said: “In patients who have breast cancer, I usually...
Oxybutynin: A Novel Option for Managing Hot Flashes?
OXYBUTYNIN, AN ANTICHOLINERGIC drug approved for the treatment of overactive bladder, reduced the frequency and intensity of hot flashes in women who were suffering frequent hot flashes, including breast cancer survivors who were receiving tamoxifen or aromatase inhibitors. These results of the...
Tumor-Infiltrating Lymphocytes and Prognosis in Early-Stage Triple-Negative Breast Cancer
In a pooled analysis reported in the Journal of Clinical Oncology, Loi et al found that levels of stromally located tumor infiltrating lymphocytes (sTILs) are strongly prognostic in early-stage triple-negative breast cancer, with improved survival observed in patients with higher levels of sTILs...
Expert Point of View: Carlos L. Arteaga, MD
PRESS CONFERENCE moderator Carlos L. Arteaga, MD, Director, Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, said that oncologists typically do not test triple-negative breast cancer for basal-like or non–basal-like features....
Role of Adjuvant Capecitabine in Triple-Negative Breast Cancer
ADJUVANT CAPECITABINE added to standard neoadjuvant chemotherapy failed to significantly improve disease-free or overall survival in patients with early triple-negative breast cancer in the large phase III CIBOMA/2004-01_GEICAM/2003-11 (CIBOMA/GEICAM) trial.1 However, extended treatment with...
Expert Point of View: Virginia G. Kaklamani, MD; Monica Morrow, MD; and John Cole, MD
AT THE SAN ANTONIO Breast Cancer Symposium, several breast cancer experts interviewed by The ASCO Post noted that the approved dose of tamoxifen was arbitrarily set, and the optimal dose is actually unknown. Studies of lower-dose tamoxifen, therefore, are welcomed. Virginia G. Kaklamani, MD,...
Low-Dose Tamoxifen Halves Breast Cancer Risk in Women With Preinvasive Breast Lesions
A VERY LOW DOSE of tamoxifen—5 mg/d, given for 3 years rather than 5 years—halved the risk of breast cancer recurrence or new lesions over placebo in women with breast intraepithelial neoplasia, without producing the usual toxicities seen with the standard dose, Italian researchers reported at the...
MRI Background Parenchymal Enhancement and Risk of Breast Cancer
In a population-based study reported in the Journal of Clinical Oncology, Arasu and colleagues found that increased breast magnetic resonance imaging (MRI) background parenchymal enhancement was associated with an increased risk of breast cancer, with risk being independent of breast density. The...
FDA Approves Biosimilar Trastuzumab-dttb
On January 18, the U.S. Food and Drug Administration (FDA) approved trastuzumab-dttb (Ontruzant), a biosimilar referencing trastuzumab, across all eligible indications—namely, adjuvant treatment of HER2-overexpressing breast cancer, metastatic breast cancer, and metastatic gastric cancer or...
Breast Cancer Surveillance Consortium Analysis of Trends in Breast Density Assessment
In a study reported in the Journal of the National Cancer Institute, Sprague et al found that only small changes in the proportions of women found to have dense breasts on digital mammography have occurred with revisions in Breast Imaging Reporting and Data System (BI-RADS) density classification...
