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As reported in The New England Journal of Medicine by Javier Cortés, MD, PhD, and colleagues, the phase III KEYNOTE-355 trial has shown improved overall survival with the addition of pembrolizumab to chemotherapy in previously untreated patients with advanced triple-negative breast cancer with a...
The final overall survival analysis of the phase III PALOMA-2 trial has shown no significant benefit for palbociclib given with letrozole, vs letrozole and placebo, as a first-line treatment in hormone receptor–positive, HER2-negative metastatic breast cancer.1 The results were reported at the 2022 ...
ASCO has issued a new practice guideline update on the use of systemic therapy for HER2-positive breast cancer, just 4 years after the previous practice guideline update was released in 2018.1,2 This latest update reviews results from multiple clinical trials published between 2016 and 2021 that...
For some patients aged 55 or older with early-stage, low-risk breast cancer, endocrine therapy following breast-conserving surgery may be sufficient without the need for postoperative radiation therapy, according to the results of the prospective LUMINA trial, reported at the 2022 ASCO Annual...
It has been 14 years since a collaboration between the University of California, Los Angeles (UCLA) and Pfizer identified a unique role for cyclin-dependent kinase 4/6 (CDK4/6) inhibitors in estrogen receptor (ER)-positive human cell line models and demonstrated that these agents act...
Telling children about their mother’s risk of hereditary breast and/or ovarian cancer does not adversely influence the offspring’s lifestyle or quality of life in the long term, according to a new study published by McDonnell et al in the journal Pediatrics. The study looked at the mutation status...
In a Canadian single-institution feasibility study reported in JACC: CardioOncology, Amy A. Kirkham, PhD, of the University of Toronto, and colleagues found that a time-restricted eating intervention reduced cardiovascular risk among older breast cancer survivors with risk factors for...
As reported in The New England Journal of Medicine by Gabriel N. Hortobagyi, MD, of the Department of Breast Medical Oncology, MD Anderson Cancer Center, Houston, and colleagues, the protocol-specified final overall survival analysis of the phase III MONALEESA-2 trial has shown a significant...
Although aromatase inhibitors are effective in reducing estrogen levels and the risk of cancer recurrence in women diagnosed with hormone receptor–positive breast cancer, they can also cause myriad side effects, including genitourinary problems associated with menopause such as vaginal dryness,...
This is Part 4 of Updates in HER2-Positive Breast Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Carey K. Anders, Erika Hamilton, and Sara A. Hurvitz discuss the management of HER2-positive residual disease. The patient is a 39-year-old premenopausal woman who is diagnosed with T2 N1 ER/PR-negative, HER2-positive breast cancer. She goes on to receive docetaxel/carboplatin/trastuzumab/pertuzumab for 6 cycles, but at surgery she is found to have T1c and N0 residual disease. The faculty discuss strategies to prevent recurrence in patients with residual disease, reviewing the findings of the KATHERINE trial of trastuzumab vs ado-trastuzumab emtansine. They also explore strategies to prevent CNS recurrence and review upcoming trials.
This is Part 3 of Updates in HER2-Positive Breast Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Carey K. Anders, Erika Hamilton, and Sara A. Hurvitz discuss the management of HER2-positive early-stage breast cancer. The patient is a 63-year-old woman with a T1c N0, ER/PR-positive, HER2-positive invasive ductal carcinoma. The faculty discuss results of the APT study and 7-year follow-up of the BCIRG-006 study, highlighting de-escalation strategies that balance the risk of recurrence with risk of side effects. They also touch on financial toxicity concerns, and the role of biosimilars in overcoming this challenge.
This is Part 2 of Updates in HER2-Positive Breast Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Carey K. Anders, Erika Hamilton, and Sara A. Hurvitz discuss the management of metastatic HER2-positive breast cancer with brain metastases. The patient is a 46-year-old woman with a history of de novo ER/PR-negative, HER2-positive breast cancer with liver metastases. Her hepatomegaly resolves and liver metastases improve after 6 cycles of docetaxel/trastuzumab/pertuzumab, but during routine restaging scans she is found to have progression in the liver and the brain. The faculty discuss the clinical implications of two phase III studies in patients with breast cancer brain metastases: HER2CLIMB, which evaluated the addition of tucatinib to trastuzumab and capecitabine, and DESTINY-Breast03, which compared fam-trastuzumab deruxtecan-nxki to ado-trastuzumab emtansine.
This is Part 1 of Updates in HER2-Positive Breast Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Carey K. Anders, Erika Hamilton, and Sara A. Hurvitz discuss the management of metastatic HER2-positive breast cancer. The patient is a 46-year-old woman with a history of de novo ER/PR-negative, HER2-positive breast cancer with liver metastases. Her hepatomegaly resolves and liver metastases improve after 6 cycles of docetaxel/trastuzumab/pertuzumab, but during routine restaging scans she is found to have progression in the liver and several pulmonary nodules. In light of this case, the faculty review the findings of the recent phase III DESTINY-Breast03 trial, which evaluated fam-trastuzumab deruxtecan-nxki in the second-line setting, and emphasize the importance of monitoring for metastatic disease while on dual antibody therapy. Additional antibody-drug conjugates currently in development are also discussed.
In the Korean phase II Neo-PATH trial reported in JAMA Oncology, Ahn et al found that neoadjuvant treatment with atezolizumab, pertuzumab/trastuzumab, and docetaxel produced a pathologic complete response in 61% of patients with HER2-positive stage II/III breast cancer treated with the regimen....
Rapid developments over the past decade in the treatment of patients with advanced HER2-positive breast cancer may lead to better outcomes and improved quality of life for patients with brain metastases, according to findings incorporated into a new ASCO guideline update.1 “The difference this...
As reported in the Journal of Clinical Oncology by Jens Huober, MD, and colleagues, the phase III IMpassion050 trial showed no significant improvement in pathologic complete response rate with the addition of atezolizumab to neoadjuvant pertuzumab/trastuzumab and chemotherapy in patients with...
New drugs for HER2-positive breast cancer are able to overcome some of the obstacles that have made brain metastases challenging to treat, according to Mark Pegram, MD, the Susy Yuan-Huey Hung Professor of Oncology at Stanford University School of Medicine in California, who described the promising ...
In a prospective single-institution study reported in JAMA Oncology, Giacomo Montagna, MD, MPH, and colleagues found that the risk for breast cancer–related lymphedema after axillary lymph node dissection was increased in Black and Hispanic patients, those who received neoadjuvant chemotherapy, and ...
The treatment of breast cancer abounding in the protein HER2 was revolutionized with the introduction of drugs like trastuzumab that target the protein. When researchers discovered that breast cancers with lower levels of HER2 often respond to a trastuzumab-and-chemotherapy drug conjugate, they...
As reported in The Lancet Oncology by Howell et al, the phase II FAKTION trial has shown improved overall survival with the addition of the AKT inhibitor capivasertib to fulvestrant in patients with estrogen receptor–positive, HER2-negative advanced breast cancer who experienced disease relapse or...
In a cohort study reported in JAMA, Karla Kerlikowske, MD, and colleagues found that screening with digital breast tomosynthesis (DBT) vs digital mammography was not associated with a lower risk of interval invasive breast cancer and was associated with a reduced risk of diagnosis of advanced...
Black and Asian women are more likely than White women to experience significant delays in getting breast biopsies after a mammogram identifies an abnormality. Moreover, those delays appear to be influenced by screening site–specific factors that may stem from structural racism, according to...
The group of compounds called parabens, which are found in widely used hair and personal care products, may increase breast cancer risk in Black women—more so than in White women—according to a study presented at ENDO 2022, the Endocrine Society’s Annual Meeting. One in eight women in the United...
Women who are longer-term survivors of metastatic breast cancer may have a worse survival rate if they have diabetes and poorly controlled blood sugar levels, according to a new study presented at ENDO 2022, the Endocrine Society’s Annual Meeting. This is the first study to specifically examine the ...
Debu Tripathy, MD, Professor and Chair of Breast Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston, shared his thoughts on TROPiCS-02 with The ASCO Post. He said the study is important because it addresses the needs of “a population with limited options, whose...
For advanced breast cancer that is hormone receptor–positive and HER2-negative, sacituzumab govitecan-hziy significantly reduced the risk of disease progression by 34% over physician’s choice of treatment, based on the results of the phase III TROPiCS-02 trial.1 The heavily pretreated patients in...
Invited discussant Patricia LoRusso, DO, PhD, of Yale School of Medicine, said to the assembled audience at the 2022 ASCO Annual Meeting: “I see you are as excited about these data as I am,” after the applause ended following Dr. Modi’s presentation. “I want to thank our colleagues for helping to...
The antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) doubled progression-free survival compared with chemotherapy alone in patients with “HER2-low” metastatic breast cancer—ie, patients with low levels of HER2 expression. The agent also extended overall survival for patients with low ...
New research published by Zeng et al in JNCCN—Journal of the National Comprehensive Cancer Network raises issues with clinical trial findings that show adjuvant hormone therapy–related hot flashes predict better treatment outcomes among patients with estrogen receptor–positive breast cancer. The...
Research shows that what we eat may influence our cancer risk, but it’s not always clear which foods or dietary patterns are best for cancer prevention. Results from a new study presented by Shah et al during Nutrition 2022 Live Online, the annual meeting of the American Society for Nutrition,...
A new perspective piece authored by researchers from the American Cancer Society and The University of Texas Health Science Center at San Antonio shows the high burden of breast cancer mortality among Black women as compared to White women began in the United States in the 1980s. At that time,...
Etienne Brain, MD, PhD, of the Institut Curie, discusses phase III findings from the Unicancer ASTER 70s trial, in which patients aged 70 or older with estrogen receptor–positive, HER2-negative breast cancer and a high genomic grade index received adjuvant endocrine therapy with or without chemotherapy. The data did not find a statistically significant overall survival benefit with this treatment after surgery (Abstract 500).
The disparities in female breast cancer incidence and mortality among racial and ethnic groups is well documented. Studies show that while Black women have a lower incidence of breast cancer compared with White women, they are 41% more likely to die from the disease than White women. Breast cancer...
Ann H. Partridge, MD, MPH, of Dana-Farber Cancer Institute, and Véronique Diéras, MD, of the Centre Eugène Marquis, discuss the many challenges posed by next-generation antibody-drug conjugates (ADCs). They include side effects such as hematotoxicity, gastrointestinal toxicities, and interstitial lung disease; tumor targeting and payload release; drug resistance; and the urgent need to understand ADCs’ mechanisms of action to better sequence and combine drugs.
Ann H. Partridge, MD, MPH, Dana-Farber Cancer Institute, and Ian E. Krop, MD, PhD, of Yale Cancer Center, discuss phase I/II findings on patritumab deruxtecan, a HER3-directed antibody-drug conjugate, in patients with HER3-expressing metastatic breast cancer. A pooled analysis showed antitumor activity in women with HR-positive/HER2-negative and HER2-positive advanced disease, as well as triple-negative breast cancer (Abstract 1002).
Erika Hamilton, MD, of Sarah Cannon Research Institute at Tennessee Oncology, discusses phase III data from the DESTINY-Breast03 study, which reinforced the consistent safety profile of fam-trastuzumab deruxtecan-nxki (T-DXd) vs ado-trastuzumab emtansine (T-DM1) in patients with HER2-positive unresectable and/or metastatic breast cancer. The findings also support T-DXd’s risk benefit over that of T-DM1 (Abstract 1000).
In a prespecified analysis from the phase III monarchE trial reported in JAMA Oncology, Miguel Martín, MD, PhD, and colleagues found that the addition of adjuvant abemaciclib to endocrine therapy was associated with improved outcomes among women with high-risk hormone receptor–positive,...
In a Canadian phase III trial reported in JAMA Oncology, Vesprini et al found that receipt of adjuvant breast radiotherapy in the supine position was associated with increased risk of moist desquamation of skin vs receipt in the prone position among large-breasted women with breast cancer. Study...
As reported in JAMA by Pamela J. Goodwin, MD, MSc, FRCPC, FASCO, the phase III MA.32 trial showed no invasive disease–free survival benefit with metformin vs placebo in patients without diabetes receiving standard therapy for high-risk nonmetastatic breast cancer. Study Details In the double-blind ...
Lisa A. Carey, MD, of the University of North Carolina Lineberger Comprehensive Cancer Center, and Shanu Modi, MD, of Memorial Sloan Kettering Cancer Center, discuss the phase III findings from the DESTINY-Breast04 trial, which compared fam-trastuzumab deruxtecan-nxki (T-DXd) vs treatment of physician’s choice (TPC) in patients with HER2-low unresectable and/or metastatic breast cancer. T-DXd is the first HER2-targeted therapy to demonstrate clinically meaningful improvement in progression-free and overall survival compared with TPC in this patient population, regardless of hormone receptor or immunohistochemistry status or prior use of CDK4/6 inhibitors (Abstract LBA3).
Ann H. Partridge, MD, MPH, of Dana-Farber Cancer Institute, and Kevin Kalinsky, MD, of Winship Cancer Institute at Emory University, discuss phase II findings from the MAINTAIN trial, which showed a benefit in progression-free survival for patients with hormone receptor–positive/HER2-negative metastatic breast cancer when they switched to endocrine therapy and received ribociclib after disease progression on another CDK4/6 inhibitor (Abstract LBA1004).
Nancy Davidson, MD, of the Fred Hutchinson Cancer Research Center, reviews results from four abstracts about the importance of long-term follow-up in studies of adjuvant endocrine therapy for hormone receptor–positive breast cancer. Because the natural history of hormone receptor–positive breast cancer is long, an effort is underway to improve selection of patients by clinical parameters or biomarkers, refine the endocrine therapy background, and administer more effective combinations of endocrine therapy with other agents.
In a study presented at the 2022 ASCO Annual Meeting (Abstract 103) and simultaneously reported in the Journal of Clinical Oncology, Lipsyc-Sharf et al found that personalized circulating tumor DNA (ctDNA) testing was successful in detecting measurable residual disease (MRD) prior to late clinical...
A new ASCO guideline update provides further recommendations on the use of biomarkers to guide decision-making on adjuvant endocrine therapy and chemotherapy in patients with early-stage breast cancer.1 The update includes clarification of the use of certain genomic tests, based on age or...
In the single-center phase II TUXEDO-1 trial of patients with advanced HER2-positive breast cancer, fam-trastuzumab-deruxtecan-nxki (T-DXd) showed efficacy in patients with active brain metastases, yielding intracranial responses in 73.3% of the population and a median progression-free survival of...
On May 4, 2022, fam-trastuzumab deruxtecan-nxki (T-DXd) was granted regular approval for patients with unresectable or metastatic HER2-positive breast cancer who have received a prior anti-HER2–based regimen in the metastatic setting or in the neoadjuvant or adjuvant setting and have developed...
Preliminary results of the basket BEGONIA trial showed that the antibody-drug conjugate datopotamab deruxtecan (Dato-DXd), paired with the immune checkpoint inhibitor durvalumab, has strong activity in advanced or metastatic triple-negative breast cancer among patients not biomarker-selected for...
Since the introduction of trastuzumab in the late 1990s, overall survival for patients with HER2-positive metastatic breast cancer has substantially improved. Median overall survival in the pivotal first-line trial was only 20.3 months in the chemotherapy arm, and 25.1 months in the...
In an updated analysis of the phase III MONALEESA-3 trial, which included postmenopausal patients with hormone receptor–positive, HER2-negative advanced or metastatic breast cancer, first-line treatment with ribociclib plus fulvestrant added nearly 16 months of overall survival time vs fulvestrant...
As reported in The New England Journal of Medicine by Javier Cortés, MD, PhD, of the International Breast Cancer Center, Barcelona, and colleagues, the phase III DESTINY-Breast03 trial has shown significantly prolonged progression-free survival with fam-trastuzumab deruxtecan-nxki (T-DXd) vs...