NSABP B-42 Trial 10-Year Update: Impact of Extended Letrozole on Disease-Free Survival
“In the 10-year analysis of the NSABP B-42 trial, the effect of extended treatment with 5 years of letrozole on disease-free survival persisted and reached statistical significance. There was no significant improvement in overall survival with letrozole, but letrozole continued to provide a...
Investigators in Brazil Explore Availability, Cost, and Use of Biosimilar Trastuzumab in Patients With HER2-Positive Breast Cancer
Investigators in Brazil are seeking to explore the efficacy and safety of adjuvant biosimilar trastuzumab in a real-world study of patients with early HER2-positive breast cancer. In 2019, biosimilar trastuzumab became the first biosimilar approved in Brazil for the treatment of patients with...
Small Study Explores Impact of Novel Regimen on Pembrolizumab for Triple-Negative Breast Cancer
In the phase II KEYNOTE-890 trial, patients with inoperable advanced triple-negative breast cancer who received one intratumoral tavokinogene telseplasmid injection followed by electroporation and pembrolizumab, several patients with skin or subcutaneous tumors saw metastatic lesions disappear,...
Phase III SOPHIA Trial Evaluates Margetuximab/Chemotherapy vs Trastuzumab/Chemotherapy for HER2-Positive Breast Cancer
The second interim analysis of the phase III SOPHIA trial demonstrated a significant though modest improvement in progression-free survival, response rate, and clinical benefit with the addition of margetuximab to chemotherapy vs trastuzumab plus chemotherapy in patients with HER2-positive...
Phase III KEYNOTE-522: Pembrolizumab Benefits Outcome in Neoadjuvant, Adjuvant Settings in Triple-Negative Breast Cancer
In patients with triple-negative breast cancer, the addition of pembrolizumab to neoadjuvant and adjuvant chemotherapy achieves higher rates of pathologic complete response compared with placebo, according to results of the phase III KEYNOTE-522 trial presented at the 2019 San Antonio Breast Cancer ...
Adding Capecitabine to Systemic Therapies Improves Outcomes in Triple-Negative Breast Cancer
Capecitabine improves disease-free and overall survival for patients with triple-negative breast cancer, but only when it is added to other systemic therapies, not when it is used as a substitute, according to a large meta-analysis of the effects of capecitabine in early breast cancer, The results...
Expert Point of View: A. Jo Chien, MD
A. Jo Chien, MD, Associate Professor at UCSF’s Helen Diller Comprehensive Cancer Center, San Francisco, was the formal discussant of this abstract. Dr. Chien said that a median follow-up of 3-years is relatively short for this trial, considering about 75% of patients had hormone receptor–positive...
Adjuvant Ado-Trastuzumab Emtansine vs Paclitaxel Plus Trastuzumab in Early HER2-Positive Breast Cancer
Results of the randomized, phase II ATEMPT trial showed that the antibody-drug conjugate ado-trastuzumab emtansine (T-DM1) failed to demonstrate improved safety when compared with paclitaxel plus trastuzumab as adjuvant therapy in patients with stage 1 HER2-positive breast cancer. These results of...
Expert Point of View: Steven J. Isakoff, MD, PhD
Steven J. Isakoff, MD, PhD, a medical oncologist at Massachusetts General Hospital, Boston, commented on the results of the DESTINY-Breast01 trial. “These data are extraordinarily encouraging, suggesting we will have another new option for patients with metastatic HER2-positive breast cancer. The...
Phase II DESTINY-Breast01: T-DXd Effective in Pretreated, Metastatic HER2-Positive Breast Cancer
In heavily pretreated patients with HER2-positive metastatic breast cancer [fam-]trastuzumab deruxtecan-nxki (T-DXd), a novel antibody-drug conjugate, achieved high response rates and durable responses, according to results of the phase II DESTINY-Breast01 trial presented at the 2019 San Antonio...
Expert Point of View: Steven J. Isakoff, MD, PhD
“With longer follow-up, the addition of pertuzumab to chemotherapy and trastuzumab appears to show benefit in hormone receptor–positive patients as well. In practice, we offer this regimen to node-positive patients and we are encouraged that hormone receptor-positive and -negative patients have a...
Chemotherapy, Trastuzumab, and Pertuzumab in Early HER2-Positive, Node-Positive Breast Cancer: Six-Year Follow-up of APHINITY Trial
Martine J. Piccart, MD, PhD, FASCO, reported that at 6-year follow-up of the APHINITY trial there was a modest, but not statistically significant, overall survival benefit for the addition of pertuzumab to chemotherapy plus trastuzumab vs chemotherapy/trastuzumab as adjuvant therapy in patients...
Phase III HER2CLIMB Trial Yields Positive Data in Patients With HER2-Positive Metastatic Breast Cancer and Brain Metastasis
The investigational oral agent tucatinib added to trastuzumab/capecitabine reduced the risk of death by one-third and reduced the risk of disease progression or death by one-half in patients with heavily pretreated metastatic HER2-positive breast cancer, including those with untreated or previously ...
Conference Highlights From the 2019 San Antonio Breast Cancer Symposium
More than 7,500 specialists in breast oncology from over 90 countries attended the 2019 San Antonio Breast Cancer Symposium (SABCS) held last December. Researchers convened to present a wide-ranging array of abstracts and posters featuring important new data in the treatment of breast cancer....
Anthracycline-Based Chemotherapy vs Docetaxel/Capecitabine: What’s the Better Adjuvant Therapy for Early Breast Cancer?
As reported in the Journal of Clinical Oncology by Delaloge et al, a second randomized component of the phase III EORTC 10041/BIG 3-04 MINDACT trial, though underpowered, suggested no benefit of docetaxel/capecitabine vs standard anthracycline-based adjuvant therapy for patients with early breast...
AI Algorithms Plus Radiologist Assessment May Help Improve Accuracy in Reading Mammography Results
An ensemble of machine-learning algorithms could help improve the accuracy of breast cancer screenings when used in combination with assessments from radiologists, according to a study published by Schaffter et al in JAMA Network Open. The study was based on results from the Digital Mammography...
Neoadjuvant and Adjuvant Pembrolizumab in Early Triple-Negative Breast Cancer
As reported in The New England Journal of Medicine by Peter Schmid, MD, PhD, and colleagues, interim analyses of the phase III KEYNOTE-522 trial have shown that the addition of pembrolizumab to neoadjuvant chemotherapy and use of adjuvant pembrolizumab vs placebo resulted in improvements in...
Weight Gain After Breast Cancer Diagnosis in Australia: Survey Results
New study findings suggest that weight gain after breast cancer is a greater problem than previously thought. The first national survey on weight after breast cancer in Australia, published by Ee et al in BMC Cancer, found close to two-thirds (63.7%) of women reported weight gain at an average of...
FDA Pipeline: Priority Review in Lung Cancer, Breakthrough Therapy Designation in Head and Neck Cancer, and More
This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to brigatinib for the treatment of ALK-positive lung cancer and Breakthrough Therapy designation to a potential first-in-class oral antagonist of inhibitors of apoptosis proteins for the treatment of head and neck...
Abbreviated Breast MRI vs Digital Breast Tomosynthesis Screening in Women With Dense Breasts
As reported in JAMA by Christiane K. Kuhl, MD, PhD, and colleagues, the ECOG-ACRIN EA1141 trial has shown that abbreviated breast magnetic resonance imaging (MRI) was associated with a significantly higher invasive breast cancer detection rate vs digital breast tomosynthesis among women with dense...
Are There Differences in Treatment and Outcomes for African American and White Women With Triple-Negative Breast Cancer?
In a study using Henry Ford Health System data reported in a research letter in JAMA Surgery, Chen et al found little difference in treatment and outcomes between African American and white women with nonmetastatic triple-negative breast cancer. Screen detection of disease was associated with...
FDA Approves Neratinib/Capecitabine for Pretreated Patients With Metastatic HER2-Positive Breast Cancer
On February 25, the U.S. Food and Drug Administration (FDA) approved neratinib (Nerlynx), a tyrosine kinase inhibitor, in combination with capecitabine for adult patients with advanced or metastatic HER2-positive breast cancer who have received two or more prior anti-HER2–based regimens in the...
Trastuzumab Deruxtecan in HER2–Low-Expressing, Previously Treated Advanced Breast Cancer
In a phase Ib study reported in the Journal of Clinical Oncology, Shanu Modi, MD, and colleagues found that the antibody-drug conjugate trastuzumab deruxtecan was active in HER2–low-expressing, previously treated advanced breast cancer. The drug component is a topoisomerase I inhibitor. The agent...
Expert Point of View: Kevin Kalinsky, MD, MS
Commenting on SAFIR02-IMMUNO for The ASCO Post, Kevin Kalinsky, MD, MS, Associate Professor of Medicine at NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, said the findings of the analysis were in accordance with other studies in metastatic breast cancer, but they came...
Mixed Results With Durvalumab Maintenance in HER2-Negative Advanced Breast Cancer
Given as maintenance therapy, the checkpoint inhibitor durvalumab significantly improved overall survival in patients with metastatic triple-negative breast cancer and yielded a numerical but not significant benefit as well for patients expressing programmed cell death ligand 1 (PD-L1), in...
Addition of Capivasertib to Fulvestrant in Advanced ER-Positive Breast Cancer After Relapse or Disease Progression With Aromatase Inhibitor Treatment
In the phase II FAKTION trial reported in The Lancet Oncology, Jones et al found that the addition of the AKT inhibitor capivasertib to endocrine therapy with fulvestrant prolonged progression-free survival in postmenopausal women with aromatase inhibitor–resistant, estrogen receptor (ER)-positive, ...
Using Antioxidants and Other Supplements With Chemotherapy May Increase Risk of Breast Cancer Recurrence and Mortality
Using antioxidants and other dietary supplements before and during adjuvant chemotherapy for breast cancer may increase the risk of recurrence and “to a lesser extent, death,” according to an analysis of dietary and nutritional data from a phase III trial, published in the Journal of Clinical...
Neoadjuvant Cisplatin for BRCA-Mutation Carriers: Pruning the Dead Branches
At the 2019 San Antonio Breast Cancer Symposium, Nadine Tung, MD, of Beth Israel Deaconess Medical Center, presented a multisite study called INFORM, run by the Translational Breast Cancer Research Consortium.1 It compared single-agent cisplatin with a “classic” combination of doxorubicin and...
Postmenopausal Estrogen and Risk of Breast Cancer: What Is the Real Story?
I am responding to an article in the January 25, 2020, issue of The ASCO Post on the conclusion of the 19-year follow-up on the Women’s Health Initiative (WHI) presented by Rowan T. Chlebowski, MD, PhD, at the 2019 San Antonio Breast Cancer Symposium: Postmenopausal estrogen administration does not ...
No Improved Pathologic Complete Response With Atezolizumab in Early Triple-Negative Breast Cancer
The addition of the checkpoint inhibitor atezolizumab to chemotherapy with carboplatin and nab-paclitaxel failed to significantly improve pathologic complete response rates compared with chemotherapy alone in patients with early high-risk, locally advanced triple-negative breast cancer. According...
Addition of Pembrolizumab to Neoadjuvant Chemotherapy in Early-Stage HER2-Negative Breast Cancer
As reported in JAMA Oncology by Rita Nanda, MD, and colleagues, findings from the ongoing phase II I-SPY 2 trial indicated that the addition of pembrolizumab to standard neoadjuvant chemotherapy improved pathologic complete response rates in patients with high-risk stage II/III HER2-negative breast ...
FDA Pipeline: Priority Reviews in Lymphoma, Lung Cancer, GIST, and Breast Cancer
This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to agents in lymphoma, lung cancer, gastrointestinal stromal tumors, and breast cancer, and granted Fast Track designation to a first-in-class radioenhancer hafnium oxide nanoparticle in head and neck cancer. Priority...
Ivana Sestak, PhD, on Clinical Treatment Score From TAILORx: Predicting Distant Breast Cancer Recurrence
Ivana Sestak, PhD, of Queen Mary University of London and the Centre for Cancer Prevention, discusses study findings that confirm the prognostic ability of the Clinical Treatment Score at 5 years (CTS5) for late distant recurrence, specifically for patients older than 50 years and/or for those deemed to have intermediate- or high-risk hormone receptor–positive, HER2-negative, node-negative breast cancer. The CTS5 is less prognostic in women younger than 50 who received 5 years of endocrine therapy alone (Abstract GS4-03).
Hongchao Pan, PhD, on an Update on 5 Years of Endocrine Therapy for Early Breast Cancer
Hongchao Pan, PhD, of the University of Oxford, discusses an analysis of 86,000 women in the Early Breast Cancer Trialists’ Collaborative Group database, which showed that the risk of distant recurrence 20 years after a diagnosis of node-negative, estrogen receptor–negative early-stage breast cancer in women who discontinued endocrine therapy at 5 years is likely to be about a third lower now than in his group’s previous report (Abstract GS2-04).
Low-Fat Diets With Increased Vegetable, Fruit, and Grain Intake Linked to Reduced Risk of Breast Cancer Mortality in Postmenopausal Women
As reported in the Journal of Clinical Oncology by Rowan T. Chlebowski, MD, PhD, and colleagues, 20-year follow-up of the Women’s Health Initiative Dietary Modification trial has shown a maintained reduction in non–breast cancer-related mortality after breast cancer diagnosis and the emergence of a ...
Elizabeth A. Mittendorf, MD, PhD, on Mobilizing the Immune System to Treat Select Solid Tumors
Elizabeth A. Mittendorf, MD, PhD, of Dana-Farber Cancer Institute and Brigham and Women’s Hospital, summarizes a session she co-chaired on utilizing the immune system in neoadjuvant trials to treat melanoma, breast, and lung cancers.
Expert Point of View: Sara M. Tolaney, MD, MPH
Sara M. Tolaney, MD, MPH, Assistant Professor of Medicine at Harvard Medical School and Associate Director of the Susan F. Smith Center for Women’s Cancers at Dana-Farber/Brigham and Women’s Cancer Center, Boston, commented on KEYNOTE-890. “Previous work has suggested minimal activity of...
Triple-Negative Breast Cancer Responds to Novel Therapy
The phase II KEYNOTE-890 trial is a small but interesting study in patients with inoperable advanced triple-negative breast cancer. After one injection of intratumoral tavokinogene telseplasmid, a plasmid encoding the proinflammatory cytokine interleukin-12 (IL-12), followed by electroporation and...
Neoadjuvant and Adjuvant Pembrolizumab Improves Pathologic Complete Response Rate in Triple-Negative Breast Cancer
The addition of pembrolizumab to neoadjuvant and adjuvant chemotherapy achieves higher rates of pathologic complete response compared with placebo in patients with triple-negative breast cancer, according to results of the phase III KEYNOTE-522 trial presented at the 2019 San Antonio Breast Cancer...
Study Finds Women With Variants in Breast Cancer–Associated Genes May Not Always Be Receiving Guideline-Concordant Care
Women with early-stage breast cancer who test positive for an inherited genetic variant are not always receiving cancer treatment that follows current treatment guidelines, according to findings from a new study published by Allison W. Kurian, MD, MSc, and colleagues in JAMA Oncology. An inherited ...
Is Distance to Treatment a Burden for Rural Patients With Breast Cancer?
A study published by Longacre et al in The Journal of Rural Health found that patients with breast cancer in the rural United States typically travel three times farther than those who live in urban areas for radiation therapy. Researchers examined data from the Surveillance, Epidemiology, and End ...
Expert Point of View: Harold J. Burstein, MD, PhD, FASCO
Commenting on Dr. DeMichele’s poster presentation at the 2019 San Antonio Breast Cancer Symposium, Harold J. Burstein, MD, PhD, FASCO, Professor of Medicine at Harvard Medical School and a medical oncologist at Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Boston, told The ASCO...
Real-World Use of Palbociclib and Abemaciclib Explored in Two Studies Based on Electronic Health Records Database
Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors are changing the landscape of the treatment of hormone receptor (HR)-positive/HER2-negative breast cancer. Three CDK4/6 inhibitors are approved by the U.S. Food and Drug Administration—ribociclib, palbociclib, and abemaciclib—as first- or...
When Added to Other Systemic Therapies, Capecitabine Improves Outcomes in Triple-Negative Breast Cancer
Capecitabine is often used to treat breast cancer, but the best use of capecitabine is open for discussion. According to a large meta-analysis of the effects of capecitabine in early breast cancer, capecitabine improves disease-free and overall survival for patients with triple-negative breast...
Gabrielle Rocque, MD, MSPH, Followed Three Generations of Doctors Into a Career in Medicine
In 2017, breast cancer expert Gabrielle Rocque, MD, MSPH, received an American Cancer Society Mentored Research Scholar Grant for her work in enhancing shared decision-making for patients with advanced breast cancer. “I come from three generations of physicians,” shared Dr. Rocque. “My father (Dr. ...
Late-Stage Cancer Diagnoses After Massachusetts Health Insurance Reform Law
Advanced-stage cancer diagnoses declined following health insurance expansion in Massachusetts, likely due to increased access to screening and diagnostic services that identified cancers earlier, according to new research published by Sabik et al in the journal Medical Care. The analysis...
CMS Expands Coverage of Next-Generation Sequencing for Patients With Breast or Ovarian Cancer
On January 27, the Centers for Medicare & Medicaid Services (CMS) took action to cover U.S. Food and Drug Administration–approved or –cleared laboratory diagnostic tests using next-generation sequencing (NGS) for patients with germline ovarian or breast cancer. Over the last several years, CMS ...
Study Reports Similar Efficacy but No Less Toxicity With Adjuvant T-DM1 vs Taxane/Trastuzumab in Early Breast Cancer
The antibody-drug conjugate ado-trastuzumab emtansine (T-DM1) failed to show improved safety when compared with paclitaxel plus trastuzumab as adjuvant therapy in patients with stage 1 HER2-positive breast cancer. These results of the randomized, phase II ATEMPT trial were presented at the 2019 San ...
Expert Point of View: Steven J. Isakoff, MD, PhD
“It is encouraging that the invasive disease–free survival observed in the primary analysis is holding up, particularly in the node-positive population. With longer follow-up, the addition of pertuzumab to chemotherapy and trastuzumab appears to show benefit in hormone receptor–positive patients as ...
APHINITY Update Supports Benefit of Pertuzumab-Based Triplet in Early HER2-Positive, Node-Positive Breast Cancer
Six-year follow-up of the APHINITY trial found a modest, but not statistically significant, overall survival benefit for the addition of pertuzumab to chemotherapy plus trastuzumab vs chemotherapy/trastuzumab as adjuvant therapy in patients with early HER2-positive breast cancer. The benefit was...
